M Abeş1, H Sarihan. 1. Department of Pediatric Surgery, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey. yaren-52@ttnet.net.tr
Abstract
PURPOSE: A wide variety of sclerosing agents have been used in the treatment of rectal prolapse (RP) in children. We have used 15 % saline solution for the first time in the treatment. The aim of this study is to review the results of a 15 % saline solution and other sclerosing agents. PATIENTS AND METHODS: A total of 16 children with RP were treated by injection of 15 % saline solution. Under general anesthesia, the patient was placed in the lithotomy position. The left index finger was inserted into the rectum to control the position of the needle, a 20-gauge spinal needle was introduced through the perianal skin and was advanced. The saline was slowly injected, the needle was then withdrawn slightly, and the injection was continued until 2 - 3 ml of 15 % saline were injected. The injection was made into the submucosal tissue, the right perirectal area, the left perirectal area, and posterior to the rectum at 5 points. RESULTS: Conservative treatment had previously failed in all patients. Prolapse ceased in 15 (93.7 %) of the 16 children after the first injection. Only one patient required a second injection. There were no complications. CONCLUSIONS: The success rates and complications of the treatment reported in the literature differ for each sclerosing agent. 15 % saline is preferable because of the high cure rate, the safety of the procedure, the easy injection, and the lack of complications.
PURPOSE: A wide variety of sclerosing agents have been used in the treatment of rectal prolapse (RP) in children. We have used 15 % saline solution for the first time in the treatment. The aim of this study is to review the results of a 15 % saline solution and other sclerosing agents. PATIENTS AND METHODS: A total of 16 children with RP were treated by injection of 15 % saline solution. Under general anesthesia, the patient was placed in the lithotomy position. The left index finger was inserted into the rectum to control the position of the needle, a 20-gauge spinal needle was introduced through the perianal skin and was advanced. The saline was slowly injected, the needle was then withdrawn slightly, and the injection was continued until 2 - 3 ml of 15 % saline were injected. The injection was made into the submucosal tissue, the right perirectal area, the left perirectal area, and posterior to the rectum at 5 points. RESULTS: Conservative treatment had previously failed in all patients. Prolapse ceased in 15 (93.7 %) of the 16 children after the first injection. Only one patient required a second injection. There were no complications. CONCLUSIONS: The success rates and complications of the treatment reported in the literature differ for each sclerosing agent. 15 % saline is preferable because of the high cure rate, the safety of the procedure, the easy injection, and the lack of complications.