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Ethanol sclerotherapy in pediatric rectal prolapse: efficacy, complications, and influencing factors

Mehdi Forooghi1,2, Fateme Ziyaee3, Hamidreza Foroutan2

  • 1Department of Pediatric Gastroenterology, Shiraz University of Medical Sciences, Shiraz, Iran.

BMC Surgery
|November 13, 2024
PubMed

Insights

Ethanol sclerotherapy is an effective treatment for pediatric rectal prolapse, with a 74.2% initial success rate. While complications are minimal, factors like male gender and constipation-dominant prolapse require careful management.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Minimally Invasive Procedures

Background:

  • Rectal prolapse significantly affects children and the elderly, with traditional surgeries posing risks.
  • Ethanol sclerotherapy presents a less invasive option by inducing rectal wall fibrosis.
  • Careful patient selection and expertise are crucial due to potential procedural complications.

Purpose of the Study:

  • To evaluate the safety and efficacy of ethanol sclerotherapy for rectal prolapse.
  • To analyze outcomes in a pediatric cohort at a tertiary referral center.

Main Methods:

  • Retrospective analysis of pediatric patient records from January 2014 to December 2023.
  • Inclusion of patients who underwent ethanol sclerotherapy for rectal prolapse.
  • Collection and statistical analysis of demographic, procedural, and outcome data.

Main Results:

  • 74.2% of 130 pediatric patients responded well to initial sclerotherapy; 12.9% required a second injection.
  • Minimal complications observed, with bleeding (4.6%) being most common; 18.6% recurrence rate.
  • Male patients had higher complication rates (P=0.010), while older age correlated with lower response and higher recurrence (P=0.017, P=0.035).

Conclusions:

  • Ethanol sclerotherapy is effective for pediatric rectal prolapse, though outcomes vary.
  • Constipation-dominant prolapse and male gender are associated with increased recurrence and complication risks, respectively.
  • Age influences treatment response and recurrence, necessitating tailored management strategies.
Abstract

Keywords:
Ethanol sclerotherapyPediatricRectal prolapse

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