A systematic review of management options in pediatric rectal prolapse

Rectal prolapse is a relatively common condition in infants and young children with a multifactorial etiology. Despite its prevalence, there remains clinical equipoise with respect to secondary treatment in pediatric surgery literature. We conducted a systematic review to evaluate methods of seconda...

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Bibliographic Details
Published in:Journal of pediatric surgery 2019-09, Vol.54 (9), p.1782-1787
Main Authors: Morrison, Zachary D., LaPlant, Melanie, Hess, Donavon, Segura, Bradley, Saltzman, Daniel
Format: Article
Language:English
Subjects:
Child
Child, Preschool
Digestive System Surgical Procedures
Humans
Infant
Laparoscopy
Pediatric
Postoperative Complications
Rectal prolapse
Rectal Prolapse - therapy
Rectopexy
Sclerotherapy
Systematic review
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Summary:Rectal prolapse is a relatively common condition in infants and young children with a multifactorial etiology. Despite its prevalence, there remains clinical equipoise with respect to secondary treatment in pediatric surgery literature. We conducted a systematic review to evaluate methods of secondary treatment currently used to treat rectal prolapse in children. We searched Pubmed, Medline, and Scopus with the terms “rectal prolapse” and “children” for papers published from 1990 to April 2017. Papers satisfying strict criteria were analyzed for patient demographics, intervention, efficacy, and complications. Procedures were grouped by like type. Pooled success rates were calculated. Twenty-seven studies documenting 907 patients were included. Injection sclerotherapy had an overall initial success rate of 79.5%. Ethyl alcohol seemed the best sclerosing agent due to a high first-injection success rate, low complication rate, and ready accessibility. Several perineal repairs were found, with operative success rates ranging from 60.8%–100%. Laparoscopic rectopexy with mesh was the most commonly reported transabdominal procedure and had an overall success rate of 96.1%. Postoperative complications from all procedures were comparable. Though many secondary treatment options have been reported for rectal prolapse, sclerotherapy and laparoscopic rectopexy predominate in contemporary literature and appear to have high success and low complication rates. IV.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2019.03.002