Department of Pediatric Gastroenterology, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Pediatric Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
BMC Surg. 2024 Nov 12;24(1):354. doi: 10.1186/s12893-024-02653-3.
Rectal prolapse is prevalent in children and the elderly, impacting quality of life significantly. Traditional surgical interventions carry risks, especially in pediatric patients. Ethanol sclerotherapy offers a less invasive alternative, inducing fibrosis and thickening of the rectal wall. Despite its potential benefits, procedural complications are possible, emphasizing the need for careful patient selection and procedural expertise. This study aims to evaluate the safety and efficacy of sclerotherapy in treating rectal prolapse in a tertiary referral center in southern Iran.
Patient records from Nemazee Hospital covering January 2014 to December 2023 were retrospectively analyzed. Pediatric patients undergoing ethanol sclerotherapy for rectal prolapse were included. Data on demographics, presentation, procedures, and outcomes were collected. Ethical approval was obtained, and specific inclusion/exclusion criteria were applied. Statistical analyses were conducted using SPSS version 26.
One hundred thirty patients were evaluated, with a mean age of 10.74 ± 5.320 years. Most patients experienced constipation (56.9%). 74.2% responded well to sclerotherapy, with 12.9% needing a second injection. Complications were minimal, with bleeding being the most common (4.6%). Recurrence occurred in 18.6% of cases. Male patients showed a higher total complication rate (P = 0.010). Diarrhea-dominant patients had no recurrences post-sclerotherapy. Age significantly influenced treatment response and recurrence (P = 0.017, P = 0.035).
Male predominance contradicted global pediatric rectal prolapse ratios, possibly influenced by cultural factors. Sclerotherapy remains effective, though response rates vary. Older age correlated with lower response rates and higher recurrence. Constipation-dominant prolapse was associated with increased recurrence risk. Male patients had a higher complication rate, highlighting the need for tailored management strategies.
直肠脱垂在儿童和老年人中较为常见，严重影响生活质量。传统手术干预存在风险，特别是在儿科患者中。乙醇硬化疗法提供了一种侵入性较小的选择，可诱导直肠壁纤维化和增厚。尽管有潜在的益处，但仍可能发生程序并发症，这强调了需要仔细选择患者和具备专业程序知识。本研究旨在评估伊朗南部一家三级转诊中心乙醇硬化疗法治疗直肠脱垂的安全性和有效性。
回顾性分析了 Nemazee 医院 2014 年 1 月至 2023 年 12 月的患者记录，纳入接受乙醇硬化疗法治疗直肠脱垂的儿科患者。收集人口统计学、表现、程序和结果的数据。获得了伦理批准，并应用了特定的纳入/排除标准。使用 SPSS 版本 26 进行了统计分析。
评估了 130 名患者，平均年龄为 10.74±5.320 岁。大多数患者有便秘（56.9%）。74.2%的患者对硬化疗法反应良好，12.9%的患者需要第二次注射。并发症很少见，最常见的是出血（4.6%）。18.6%的病例复发。男性患者的总并发症发生率更高（P=0.010）。硬化疗法后腹泻为主的患者无复发。年龄显著影响治疗反应和复发（P=0.017，P=0.035）。
男性优势与全球儿科直肠脱垂比例相矛盾，可能受文化因素影响。硬化疗法仍然有效，尽管反应率有所不同。年龄较大与较低的反应率和较高的复发率相关。以便秘为主的脱垂与增加的复发风险相关。男性患者的并发症发生率较高，这强调需要制定个性化的管理策略。
