Lei Haiyan,Guo Qin,Wang Haibin,et al.Clinical experience of alcohol sclerotherapy for children with rectal prolapse[J].Journal of Clinical Pediatric Surgery,,():658-661.[doi:10.3760/cma.j.cn101785-202409077-011]
Clinical experience of alcohol sclerotherapy for children with rectal prolapse
- Keywords:
- Rectal Prolapse; Constipation; Therapy; Injections; Child
- Abstract:
- Objective To explore the clinical characteristics of rectal prolapse (RP) in children,summarize its therapeutic experience and determine the efficacy of alcohol sclerotherapy injection for managing RP. Methods From January 2013 to December 2022,the relevant clinical data were retrospectively reviewed for 98 RP children.Initially medications or behavioral therapies were offered at resolving such underlying causes as cough,diarrhea and constipation.If these measures proved ineffective,alcohol sclerotherapy was administered to children aged above 5.For children aged under 5,alcohol sclerotherapy was prescribed if prolapse length was ≥2 cm or if there were over two episodes of incarceration. Results There were 72 boys and 26 girls with an average age of 46 month.Constipation,diarrhea,chronic cough,fecal incontinence,abnormal sacral development and colonic polyps were major comorbidities.And 35 children experienced acute impaction and 19 children were admitted into emergency department due to failed conservative resetting of an initial impaction after sedation with manual reduction and correction of the underlying causes.The remaining 79 cases underwent one or multiple rounds of alcohol sclerotherapy injection and none of them developed such postoperative complications as perianal mucosal necrosis or skin necrosis.Within 2 weeks post-injection,6 cases prolapsed again with a recurrence rate of 7.59%.After 3-month observation,4 cases were cured without any recurrence.A second injection (n=1) and a third injection (n=1) were performed.During a follow-up period of (1-6) month,all cases were clinically cured without any complication. Conclusions For RP children unresponsive to medications or behavioral therapies for cough,diarrhea,and constipation,alcohol sclerotherapy is highly safe and effective with a high curative rate.Its straightforward procedure makes it a preferred first-line surgical approach.
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Memo
收稿日期:2024-9-29。
基金项目:国家自然科学基金(81570466)
通讯作者:杨俊,Email:119064715@qq.com