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J Pediatr Surg. 2010 Oct;45(10):2103-7. doi: 10.1016/j.jpedsurg.2010.06.006.

Laparoscopic suture rectopexy for full-thickness anorectal prolapse in children: an effective outpatient procedure.

Author information

1
Division of Pediatric Surgery, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.

Abstract

BACKGROUND/PURPOSE:

Our approach to full-thickness anorectal prolapse has transitioned to laparoscopic suture rectopexy (LSRP). The purpose of this study was to describe the indications, technique, and postoperative outcomes for LSRP.

METHODS:

Rectopexy was performed using 3 or 4 laparoscopic ports. Redundant rectum was retracted from the pelvis, and the posterior rectal wall was secured to the sacral promontory using 3 permanent sutures.

RESULTS:

Nineteen children (7 girls) underwent LSRP from March 2003 to January 2008. Mean age was 6.2 ± 3.6 years. Three patients had prior perineal operations: 2 sacrococcygeal teratoma resections and 1 pull-through for Hirschsprung disease. One patient had cystic fibrosis, and another had Prader-Willi syndrome. The remaining children had either chronic constipation or idiopathic prolapse. All patients were treated preoperatively with laxatives. Two patients received antegrade continent enemas. Length of stay was 1 ± 0.8 days, with only the first 5 patients admitted to the hospital. The patient with Prader-Willi syndrome had a full-thickness recurrence (5%) owing to obsessive-compulsive behavior. Partial mucosal prolapse occurred in 2 patients. There were no other complications.

CONCLUSIONS:

Laparoscopic suture rectopexy is an effective minimally invasive method to treat full-thickness rectal prolapse in children from various etiologies. It can be performed as an outpatient procedure with minimal morbidity and low recurrence rate (5%).

PMID:
20920740
DOI:
10.1016/j.jpedsurg.2010.06.006
[Indexed for MEDLINE]

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