Bahador Abi, Foroutan Hamid Reza, Hosseini Seyed Mohammad Vahid, Davani Sam Zeraatian Nejad
Department of Pediatric Surgery, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz - 71877-33398, Iran.
J Indian Assoc Pediatr Surg. 2008 Jan;13(1):11-3. doi: 10.4103/0971-9261.42566.
Our aim in this study is to evaluate the effect of ethanol as a sclerosing agent on subset of pediatric patients with prolonged rectal prolapse.
From 1997 to 2003, 165 cases of primary rectal prolapse were treated by submucosal injection of ethyl alcohol (96%) after 8 weeks of conservative therapy. Around 1.5-2 ml of alcohol was linearly injected in three sites (two laterals and one posterior).
Twelve of the 165 cases lost the follow-up and 153 cases were followed from 9 months to 6 years. One hundred and six patients (69.3%) had a duration of prolapse for 3-7 months. Forty patients (26.1%) had prolapse for more than 7 months and seven patients had prolapse for more than 1 year. One hundred and forty-seven out of 153 (96%) patients responded to single injection. Three of the children required a second injection. Three patients with age of more than 13 did not respond to the treatment. Twenty five cases had fecal soilage for few days. No infectious complication and no recurrence were observed.
We concluded that 4-6 ml of ethyl alcohol (96%) is effective for the treatment of rectal prolapse. The duration of rectal prolapse had no deleterious effect on treatment; however, patients with age more than 13 years did not respond to sclerosing agent, probably due to different etiology.
本研究的目的是评估乙醇作为硬化剂对患有长期直肠脱垂的小儿患者亚组的疗效。
1997年至2003年，165例原发性直肠脱垂患者在保守治疗8周后接受了96%乙醇的黏膜下注射治疗。在三个部位（两侧各一处和后方一处）线性注射约1.5 - 2毫升乙醇。
165例中有12例失访，153例随访9个月至6年。106例患者（69.3%）脱垂持续时间为3 - 7个月。40例患者（26.1%）脱垂超过7个月，7例患者脱垂超过1年。153例患者中有147例（96%）单次注射有效。3名儿童需要第二次注射。3名年龄超过13岁的患者对治疗无反应。25例有几天粪便污染。未观察到感染性并发症和复发情况。
我们得出结论，4 - 6毫升96%乙醇对直肠脱垂治疗有效。直肠脱垂的持续时间对治疗无不良影响；然而，年龄超过13岁的患者对硬化剂无反应，可能是由于病因不同。
