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Postoperative complications and long-term functional outcome in children operated for idiopathic rectal prolapse
Elin Albertsdottir1, Niels Qvist2
1Surgical Department A, Odense University Hospital, Odense, Denmark.
Insights
Stapled anopexy for short rectal prolapse had a high recurrence rate, while Delorme
Area of Science:
- Colorectal Surgery
- Gastroenterology
- Surgical Outcomes
Background:
- Rectal prolapse management requires effective surgical strategies.
- Assessing long-term functional outcomes is crucial for patient quality of life.
Purpose of the Study:
- To compare stapled anopexy for short rectal prolapse (<5 cm) and Delorme's procedure for longer prolapse (>5 cm).
- To evaluate postoperative complications and long-term gastrointestinal function for both procedures.
Main Methods:
- A cohort of 38 patients with rectal prolapse underwent surgical treatment.
- Follow-up ranged from 1 month to 9.1 years, with 83% completing the Rome III questionnaire for functional assessment.
Main Results:
- Stapled anopexy (n=35) showed a 34.3% recurrence rate, with re-stapling success in 44.4%.
- Delorme's procedure (n=10) had no observed complications or recurrences.
- Functional gastrointestinal symptoms were reported by 4/19 patients after stapled anopexy and 3/8 after Delorme's procedure. No continence issues were noted.
Conclusions:
- Delorme's procedure demonstrated superior outcomes with no recurrence compared to stapled anopexy.
- Both surgical approaches yielded functional results comparable to a healthy pediatric population.
Purpose:
The aim of the present study was to evaluate the postoperative complications and the long-term gastrointestinal functional outcome after surgical treatment for rectal prolapse on a strategy with stapled anopexy for short (< 5 cm) prolapse and Delormes procedure for longer (> 5 cm) rectal prolapse.
Methods:
A total of 38 patients were included with a postoperative follow-up period ranging from 1 month to 9.1 years. Thirty patients (83%) completed the Rome III questionnaire on gastrointestinal function, with the follow-up period ranging from 2 months to 7 years.
Results:
Thirty-five patients were treated with stapled anopexy as a primary surgical treatment. One minor complication with slight postoperative bleeding was observed, but the recurrence rate was 34.3%. Treatment of recurrence with re-stapling gave success rate of 44.4%. Ten patients (3 primary and 7 with recurrence after stapled anopexy) were treated with Delormes procedure with no observed complications or recurrence. Four out of nineteen patients treated with stapled anopexy fulfilled the criteria for functional gastrointestinal symptoms and in 3 out of 8 treated with Delormes procedure. No patients reported continence problems.
Conclusion:
The recurrence rate for stapled anopexy was high and none with Delormes procedure. The functional outcome was comparable with a healthy population of children.
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