Transanal rectal mucosectomy and muscular plication: A new technique for rectal prolapse in patients with an anorectal malformation.


Journal

Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631

Informations de publication

Date de publication:
Nov 2020
Historique:
received: 17 04 2020
revised: 17 05 2020
accepted: 20 05 2020
pubmed: 27 6 2020
medline: 25 6 2021
entrez: 27 6 2020
Statut: ppublish

Résumé

Rectal prolapse after repair of an anorectal malformation (ARM) occurs at a frequency of 3.8% to 60.0%. Different techniques have been described for repair, with a recurrence rate of up to 33%. We aimed to describe a new technique for rectal prolapse and present its results. A retrospective review of our database identified 14 patients with rectal prolapse after posterior sagittal anorectoplasty (PSARP) for an ARM. The study was performed from January 2014 until March 2020. All patients underwent transanal rectal mucosectomy and muscular plication (TRMMP). All but one patient had PSARP, and the remaining patient had laparoscopic-assisted PSARP. The mean age at repair was 4 years and 8 months (range, 1-12 years). One patient had three previous repair attempts, and another five had only one attempt. The mean follow-up was 2 years and 5 months (range, 3 months to 5 years and 7 months). None of the patients experienced prolapse recurrence or postoperative complications. This preliminary report showed that TRMMP can be used for rectal prolapse, without the risk of recurrence or complications. Pediatric surgeons may consider this technique as another option for the treatment of rectal prolapse in patients with an ARM.

Sections du résumé

BACKGROUND BACKGROUND
Rectal prolapse after repair of an anorectal malformation (ARM) occurs at a frequency of 3.8% to 60.0%. Different techniques have been described for repair, with a recurrence rate of up to 33%. We aimed to describe a new technique for rectal prolapse and present its results.
METHODS METHODS
A retrospective review of our database identified 14 patients with rectal prolapse after posterior sagittal anorectoplasty (PSARP) for an ARM. The study was performed from January 2014 until March 2020. All patients underwent transanal rectal mucosectomy and muscular plication (TRMMP).
RESULTS RESULTS
All but one patient had PSARP, and the remaining patient had laparoscopic-assisted PSARP. The mean age at repair was 4 years and 8 months (range, 1-12 years). One patient had three previous repair attempts, and another five had only one attempt. The mean follow-up was 2 years and 5 months (range, 3 months to 5 years and 7 months). None of the patients experienced prolapse recurrence or postoperative complications.
CONCLUSION CONCLUSIONS
This preliminary report showed that TRMMP can be used for rectal prolapse, without the risk of recurrence or complications. Pediatric surgeons may consider this technique as another option for the treatment of rectal prolapse in patients with an ARM.

Identifiants

pubmed: 32586611
pii: S0022-3468(20)30356-0
doi: 10.1016/j.jpedsurg.2020.05.025
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2531-2535

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Luis De La Torre (L)

International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO, USA. Electronic address: luis.delatorre@childrenscolorado.org.

María Zornoza (M)

Centro Colorrectal para Niños de México y Latinoamérica, Hospital Ángeles Puebla, Mexico.

Alberto Peña (A)

International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO, USA.

Andrea Bischoff (A)

International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO, USA.

Jill Ketzer (J)

International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO, USA.

Alejandro Ruiz (A)

Centro Colorrectal para Niños de México y Latinoamérica, Hospital Ángeles Puebla, Mexico.

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Classifications MeSH