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Posterior plication of the rectum for rectal prolapse in children
C Tsugawa1, Y Matsumoto, E Nishijima
1Department of Surgery, Kobe Children's Hospital, Japan.
Insights
Posterior rectal plication effectively treated rectal prolapse in children. This surgical technique, involving rectal wall suturing to the coccyx, showed no recurrence in fourteen pediatric patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Rectal prolapse is a condition where the rectal lining protrudes from the anus.
- It commonly affects infants and young children, with various surgical interventions described.
Purpose of the Study:
- To evaluate the efficacy of posterior plication of the rectum for treating pediatric rectal prolapse.
- To determine the recurrence rate of rectal prolapse after this specific surgical procedure.
Main Methods:
- A cohort of fourteen pediatric patients (age 1-12 years) with rectal prolapse underwent the procedure.
- The surgical technique involved natal cleft incision, levator muscle separation, rectal wall dissection, plication with U-shaped sutures, and fixation to the coccyx.
Main Results:
- No recurrence of rectal prolapse was observed in any of the fourteen patients post-surgery.
- The procedure was described as simple and definitive for the condition.
Conclusions:
- Posterior plication of the rectum is a successful and effective treatment for pediatric rectal prolapse.
- The authors suggest rectal elongation as a potential cause and recommend this technique.
Abstract:
Fourteen patients with rectal prolapse (age range, 1 to 12 years) underwent posterior plication of the rectum for rectal prolapse. The procedure consisted of (1) natal cleft incision, (2) midline separation of the levator muscle, (3) dissection of two thirds of the circumference of the rectum, (4) plication of the posterior wall of the rectum using U-shaped mattress sutures, and (5) fixation of the sutures of the rectal wall to the coccyx. There has been no recurrence of prolapse in any of the patients. The authors' experience suggests that an elongated rectum is responsible for prolapse. This simple but definitive technique is recommended.