Classification and management of rectal prolapse after anorectoplasty for anorectal malformations.
Pediatr Surg Int
; 30(8): 783-9, 2014 Aug.
Article
in En
| MEDLINE
| ID: mdl-24969817
ABSTRACT
PURPOSE:
To suggest a classification, describe the risk factors and management of rectal prolapse after anorectoplasty for anorectal malformations (ARMs).METHODS:
We classified prolapse as minimal (rectal mucosa visible with Valsalva manoeuvre), moderate (prolapse <5 mm without Valsalva), evident (>5 mm without Valsalva) and compared patients with and without prolapse within our ARM-population.RESULTS:
Among 150 patients, 40 (27 %) developed prolapse 25 minimal, 6 moderate, 9 evident. Prolapse affected 33 % of males (9 % of perineal fistulas, 38 % of bulbar, 71 % of prostatic, 60 % of bladder neck and 13 % without fistula) and 21 % of females (9 % of perineal, 30 % of vestibular, 50 % of cloacas, and 25 % without fistula). Risk factors for prolapse were tethered cord (40 vs 24 %), vertebral anomalies (39 vs 24 %), laparoscopic-assisted anorectoplasty (LAARP) (75 vs 25 %), and colostomy at birth (49 vs 9 %). Redo anorectoplasty was not associated with prolapse. Symptoms were present in 11 patients (28 %) in 7 % with minimal, 33 % with moderate and 77 % with evident prolapse. Nine patients (2 moderate, 7 evident) underwent surgical correction.CONCLUSION:
Severe ARMs, tethered cord, vertebral anomalies, colostomy, and LAARP predispose to rectal prolapse. Classifying prolapse allows to predict symptoms and need for surgical correction, and to compare outcomes among different centers.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Anal Canal
/
Anus, Imperforate
/
Rectum
/
Digestive System Surgical Procedures
/
Rectal Prolapse
/
Plastic Surgery Procedures
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Infant
/
Male
/
Newborn
Language:
En
Journal:
Pediatr Surg Int
Journal subject:
PEDIATRIA
Year:
2014
Type:
Article