Posterior sagittal rectopexy in the treatment of recurrent rectal prolapse in children

Abstract

Background/purpose Several surgical techniques have been described to treat recurrent rectal prolapse in children after failure of initial surgical treatment. The aim of this study was to evaluate the safety and efficacy of posterior sagittal rectopexy (PSR) in children with recurrent rectal prolapse. Patients and methods Twenty-two patients aged between 1 and 7 years presented with recurrent rectal prolapse after failure of initial surgical treatment. Conservative management was successful in four cases. Eighteen were treated with PSR. The procedure included plication of the dilated rectum and fixation of the rectum to the sacrum. The follow-up ranged between 4 and 18 months. Results Superficial wound infection occurred in two cases, and both healed without any further consequences. Constipation improved in seven out of 12 patients, who had history of constipation before surgery. Partial mucosal prolapse recurrence occurred in three patients. Two improved conservatively after 5 months and 7 months, respectively, and one required mucosal trimming. Normal anorectal continence was noted in all patients older than 3 years at follow-up. Conclusion PSR is a good option in cases of recurrent rectal prolapse in children. The technique is both safe and effective. It is associated with satisfactory functional results. Keywords : children, complications, posterior sagittal rectopexy, rectal prolapse, recurrent