A systematic review of management options in pediatric rectal prolapse

Zachary D. Morrison, Melanie LaPlant, Donavon J Hess, Bradley J Segura, Daniel A Saltzman

Research output: Contribution to journalReview article

Abstract

Purpose: 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. Methods: 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. Results: 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. Conclusion: 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. Level of Evidence: IV.

Original languageEnglish (US)
Pages (from-to)1782-1787
Number of pages6
JournalJournal of Pediatric Surgery
Volume54
Issue number9
DOIs
StatePublished - Sep 1 2019

Fingerprint

Rectal Prolapse
Pediatrics
Sclerotherapy
Sclerosing Solutions
Literature
Injections
PubMed
Ethanol
Therapeutics
Demography

Keywords

  • Pediatric
  • Rectal prolapse
  • Rectopexy
  • Sclerotherapy
  • Systematic review

PubMed: MeSH publication types

  • Journal Article
  • Review

Cite this

A systematic review of management options in pediatric rectal prolapse. / Morrison, Zachary D.; LaPlant, Melanie; Hess, Donavon J; Segura, Bradley J; Saltzman, Daniel A.

In: Journal of Pediatric Surgery, Vol. 54, No. 9, 01.09.2019, p. 1782-1787.

Research output: Contribution to journalReview article

@article{8d94051aacf648429bc460fdc850c8c5,
title = "A systematic review of management options in pediatric rectal prolapse",
abstract = "Purpose: 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. Methods: 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. Results: 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. Conclusion: 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. Level of Evidence: IV.",
keywords = "Pediatric, Rectal prolapse, Rectopexy, Sclerotherapy, Systematic review",
author = "Morrison, {Zachary D.} and Melanie LaPlant and Hess, {Donavon J} and Segura, {Bradley J} and Saltzman, {Daniel A}",
year = "2019",
month = "9",
day = "1",
doi = "10.1016/j.jpedsurg.2019.03.002",
language = "English (US)",
volume = "54",
pages = "1782--1787",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",
number = "9",

}

TY - JOUR

T1 - A systematic review of management options in pediatric rectal prolapse

AU - Morrison, Zachary D.

AU - LaPlant, Melanie

AU - Hess, Donavon J

AU - Segura, Bradley J

AU - Saltzman, Daniel A

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Purpose: 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. Methods: 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. Results: 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. Conclusion: 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. Level of Evidence: IV.

AB - Purpose: 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. Methods: 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. Results: 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. Conclusion: 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. Level of Evidence: IV.

KW - Pediatric

KW - Rectal prolapse

KW - Rectopexy

KW - Sclerotherapy

KW - Systematic review

UR - http://www.scopus.com/inward/record.url?scp=85063113360&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85063113360&partnerID=8YFLogxK

U2 - 10.1016/j.jpedsurg.2019.03.002

DO - 10.1016/j.jpedsurg.2019.03.002

M3 - Review article

VL - 54

SP - 1782

EP - 1787

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

IS - 9

ER -