Evaluation of laparoscopic rectosigmoidopexy for the treatment of complete rectal prolapse in children

Abstract

Aim:Rectal prolapse in children is a common condition in infancy and early childhood that usually responds to conservative measures. Surgery is reserved only for resistant cases that fail to respond to conservative measures. This study was designed to evaluate the efficacy of 3-point fixation concept (retrorectal dissection, rectopexy to presacral fascia of the sacral promontory and sigmoidopexy onto the anterior abdominal wall) in treatment of complete rectal prolapse in children using laparoscopy. Methods: This prospective study was conducted on 12 children with persistent complete rectal prolapse who failed to respond to adequate conservative measures from July 2015 to July 2016. The technical details of the procedure are described. Patients were followed up for at least 6 months and were assessed clinically and radiologically for continence and constipation using the appropriate scoring systems. Results: Twelve patients were included, 8 females and 4 males, laparoscopic rectopexy and sigmoidopexy were done for all cases. The mean duration for surgery was 58.42 min. No intraoperative complications recorded. One case (8.3%) had partial thickness recurrence and 1 case had skin stitch sinus. No postoperative constipation nor incontinence was observed. Conclusion:The laparoscopic rectopexy and sigmoidopexy is an effective approach for the treatment of refractory complete rectal prolapse in children. The 3-point fixation proved efficient in controlling rectal prolapse in children with minimal complications. Key words:Laparoscopy, rectopexy, sigmoidopexy, rectal prolapse, children, 3-point fixation ABSTRACTArticle history: Received: 20-12-2016 Accepted: 07-03-2017 Published: 31-03-2017 Prof. Sameh Shehata is working as professor and past chairman of Pediatric Surgery Department, Faculty of Medicine, University of Alexandria, Egypt. He is the past president of the Egyptian Association of Pediatric Surgeons. He has a wide international activity in the field of pediatric surgery; he is the president-elect of the WOFAPS, and the cochairman of the IPEG middle east chapter. He has given over 150 lectures both nationally and internationally and was invited as a guest lecture in many national associations congresses. He is among the editorial board of many national and international pediatric surgery journals including the JPS, PSI and International Journal of Urology.