Rectal Prolapse in the Pediatric Population.

Q1 Medicine
Current Gastroenterology Reports Pub Date : 2025-12-01 Epub Date: 2024-11-23 DOI:10.1007/s11894-024-00953-5
James K Moon, John D Stratigis, Aaron M Lipskar
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引用次数: 0

Abstract

Purpose of review: Rectal prolapse in the pediatric population presents a clinical challenge with wide variability in etiology, presentation, work-up and management. In this article, we reviewed the evidence supporting various medical and surgical treatment options as well as the recent trends amongst pediatric surgeons.

Recent findings: Medical therapy is highly effective in most patients, with bowel management programs being particularly successful. Nonetheless, medically refractory disease, often seen in older children and in children with behavioral/psychiatric disorders, can be challenging. Sclerotherapy with ethanol or 5% phenol can be effective local treatments. 15% hypertonic saline, 50% dextrose, and Deflux are additional safe alternatives. Perianal procedures and perineal procedures are less invasive surgical options, but transabdominal rectopexy appears to be the favored treatment for disease refractory to local treatment. Transabdominal rectopexy with sigmoidectomy, the recommended operation in the adult population for patients with prolapse and constipation, appears only to be preferred in the pediatric population for postoperative recurrences.

Recent findings: While outcomes of medical treatment for pediatric rectal prolapse are excellent, sclerotherapy and transabdominal rectopexy are effective options for refractory disease preferred by most pediatric surgeons.

小儿直肠脱垂
审查目的:小儿直肠脱垂是一项临床挑战,其病因、表现、检查和治疗方法千差万别。在本文中,我们回顾了支持各种药物和手术治疗方案的证据,以及儿科外科医生的最新趋势:最新研究结果:药物治疗对大多数患者都非常有效,其中肠道管理方案尤为成功。然而,药物难治性疾病(通常见于年龄较大的儿童和有行为/精神障碍的儿童)可能具有挑战性。使用乙醇或 5%苯酚进行硬化剂注射是一种有效的局部治疗方法。15% 高渗盐水、50% 葡萄糖和 Deflux 也是安全的替代疗法。肛周手术和会阴手术是创伤较小的手术选择,但对于局部治疗无效的疾病,经腹直肠切除术似乎是最受欢迎的治疗方法。经腹直肠切除术加乙状结肠切除术是成人脱肛和便秘患者的推荐手术,但在儿科患者中,似乎只有术后复发的患者才会选择经腹直肠切除术:最近的研究结果:虽然小儿直肠脱垂的药物治疗效果很好,但硬化疗法和经腹直肠切除术是大多数小儿外科医生首选的治疗难治性疾病的有效方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current Gastroenterology Reports
Current Gastroenterology Reports Medicine-Gastroenterology
CiteScore
7.80
自引率
0.00%
发文量
19
期刊介绍: As the field of gastroenterology and hepatology rapidly evolves, the wealth of published literature can be overwhelming. The aim of the journal is to help readers stay abreast of such advances by offering authoritative, systematic reviews by leading experts. We accomplish this aim by appointing Section Editors who invite international experts to contribute review articles that highlight recent developments and important papers published in the past year. Major topics in gastroenterology are covered, including pediatric gastroenterology, neuromuscular disorders, infections, nutrition, and inflammatory bowel disease. These reviews provide clear, insightful summaries of expert perspectives relevant to clinical practice. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.
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