Jonathan Randall1, Hugh Gallagher2, Bruce Jaffray3. 1. Department of colorectal surgery, Newcastle Upon Tyne Hospitals, Newcastle, United Kingdom. Electronic address: jon_randall25@hotmail.com. 2. Department of colorectal surgery, Newcastle Upon Tyne Hospitals, Newcastle, United Kingdom. 3. Department of paediatric surgery, Newcastle Upon Tyne Hospitals, Newcastle, United Kingdom.
Abstract
PURPOSE: This study reports the results of laparoscopic rectopexy in children. METHODS: Results were obtained from a prospective database for all laparoscopic rectopexy procedures performed for external prolapse in a tertiary referral centre from 2006 to 2013. Outcomes included recurrence of symptoms and/or visible prolapse as well as the need for further surgery RESULTS: Eighteen procedures including both suture and mesh rectopexy were performed in 11 patients. Six had solitary rectal ulcers. All patients had failed conservative management, including laxative therapy, and one patient had previously had a trial of injection of hypertonic saline. At a median follow up of 33months (6-75) complete resolution was seen in 7 cases and partial resolution, with some continuing symptoms, was seen in 1 patient. All suture rectopexy cases ultimately failed and required a redo rectopexy procedure. Three patients had persistent failure with recurrence of prolapse during the study period despite repeated procedures. There were no serious complications. CONCLUSIONS: Laparoscopic mesh rectopexy can be safely performed in children and can lead to complete resolution of external prolapse. There is a cohort for whom it fails to relieve the problem. In this series there was a trend towards less recurrence with mesh rectopexy.
PURPOSE: This study reports the results of laparoscopic rectopexy in children. METHODS: Results were obtained from a prospective database for all laparoscopic rectopexy procedures performed for external prolapse in a tertiary referral centre from 2006 to 2013. Outcomes included recurrence of symptoms and/or visible prolapse as well as the need for further surgery RESULTS: Eighteen procedures including both suture and mesh rectopexy were performed in 11 patients. Six had solitary rectal ulcers. All patients had failed conservative management, including laxative therapy, and one patient had previously had a trial of injection of hypertonic saline. At a median follow up of 33months (6-75) complete resolution was seen in 7 cases and partial resolution, with some continuing symptoms, was seen in 1 patient. All suture rectopexy cases ultimately failed and required a redo rectopexy procedure. Three patients had persistent failure with recurrence of prolapse during the study period despite repeated procedures. There were no serious complications. CONCLUSIONS: Laparoscopic mesh rectopexy can be safely performed in children and can lead to complete resolution of external prolapse. There is a cohort for whom it fails to relieve the problem. In this series there was a trend towards less recurrence with mesh rectopexy.