Background

Rectal prolapse after repair of an anorectal malformation (ARM) occurs at a frequency of 3.8% to 60.0%. Different techniques have been described for repair, with a recurrence rate of up to 33%. We aimed to describe a new technique for rectal prolapse and present its results.

Methods

A retrospective review of our database identified 14 patients with rectal prolapse after posterior sagittal anorectoplasty (PSARP) for an ARM. The study was performed from January 2014 until March 2020. All patients underwent transanal rectal mucosectomy and muscular plication (TRMMP).

Results

All but one patient had PSARP, and the remaining patient had laparoscopic-assisted PSARP. The mean age at repair was 4 years and 8 months (range, 1–12 years). One patient had three previous repair attempts, and another five had only one attempt. The mean follow-up was 2 years and 5 months (range, 3 months to 5 years and 7 months). None of the patients experienced prolapse recurrence or postoperative complications.

Conclusion

This preliminary report showed that TRMMP can be used for rectal prolapse, without the risk of recurrence or complications. Pediatric surgeons may consider this technique as another option for the treatment of rectal prolapse in patients with an ARM.

中文翻译：

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经肛门直肠粘膜切除术和肌肉陷：一种用于肛门直肠畸形患者的直肠脱垂的新技术。

背景

肛门直肠畸形（ARM）修复后的直肠脱垂发生率为3.8％至60.0％。已经描述了用于修复的不同技术，复发率高达33％。我们旨在描述一种用于直肠脱垂的新技术并介绍其结果。

方法

回顾性分析了我们的数据库，发现14例ARM后路矢状动脉直肠成形术（PSARP）后直肠脱垂。该研究于2014年1月至2020年3月进行。所有患者均接受了经肛门直肠粘膜切除术和肌肉行术（TRMMP）。

结果

除一名患者外，所有患者均接受PSARP，其余患者接受腹腔镜辅助PSARP。修复的平均年龄为4岁8个月（范围1至12岁）。一名患者之前曾进行过三次修复尝试，而另一名患者中只有五次尝试过。平均随访时间为2年5个月（范围3个月至5年7个月）。没有患者经历脱垂复发或术后并发症。

结论

该初步报告表明，TRMMP可用于直肠脱垂，而没有复发或并发症的风险。儿科医生可能会将此技术视为治疗ARM患者直肠脱垂的另一种选择。