经肛门直肠内入路治疗儿童特发性直肠脱垂：改良Delorme手术的经验

Transanal endorectal approach for the treatment of idiopathic rectal prolapse in children: Experience with the modified Delorme's procedure.

作者信息

De la Torre Luis, Zornoza-Moreno María, Cogley Kimberly, Calisto Juan L, Wehrli Lea A, Ruiz-Montañez Alejandro, Santos-Jasso Karla

机构信息

Colorectal and Hirschsprung Center for Children at Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, University of Pittsburgh, School of Medicine, Pittsburgh, USA.

Centro Colorrectal para Niños de México y Latinoamérica, Hospital Angeles Puebla, Puebla, Mexico..

出版信息

J Pediatr Surg. 2019 Apr;54(4):857-861. doi: 10.1016/j.jpedsurg.2018.10.016. Epub 2018 Oct 12.

DOI:10.1016/j.jpedsurg.2018.10.016

PMID:30381137

Abstract

BACKGROUND

Persistent or recurrent idiopathic rectal prolapse in children requires surgical intervention. Several techniques have been used to repair this problem. However, recurrence and complications continue to be a challenge in the management of this condition. Here we report our experience in using the modified Delorme's procedure to treat such patients.

METHODS

We conducted a retrospective observational study of patients with idiopathic rectal prolapse who underwent the modified Delorme's procedure during 2013-2017. We analyzed the clinical characteristics of the patients and the recurrence and complication rates during a follow-up of 15-68 months.

RESULTS

We included 14 patients. The age at operation ranged from 2 to 17 years, and the length of the prolapse was 3-15 cm. There were no intraoperative or postoperative complications. All patients achieved postoperative fecal control, and there were no recurrences.

CONCLUSION

The modified Delorme's procedure was effective for the treatment of idiopathic rectal prolapse. There were no recurrences or complications. Because it is a perineal technique, the procedure avoids the risk of nerve injury that exists for transabdominal methods.

摘要