2010DOAJ (DOAJ: Directory of Open Access Journals)Open access

Management of Rectal Prolapse in Children: Our Experience of Thiersch Stitch Procedure

Arshad Kamal, Kifayat Khan, Muhammad Ahmad Khan, Younis Khan, Mohammad Uzair, M. Tariq, Mamoon ., Saddar Rahim

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Abstract

Background: Rectal prolapse is a common pediatric surgical problem with many treatment options. This study was conducted to assess the outcome of Thiersch stitch in the management of rectal prolapse in children. Methodology: It was a descriptive study conducted at Department of Pediatric Surgery, Lady Reading Hospital Peshawar from January 2003 to December 2008. Patients with complete rectal prolapse for more than 3 months were included. Patients were admitted 24 hours before the procedure. Kleen enema was given in the morning of operation. The procedure was performed under general anaesthesia. Vicryl size 1 was wrapped around the lower part of anal canal subcutaneously. Patients were discharged home on same day on oral analgesics for a week and laxatives for a month. They were followed in outpatient department for 3 months and any complication was recorded. Results: Sixty-five patients, 37 males and 28 females, with complete rectal prolapse were operated. Age range was 2-8 years. No complication was seen during operation. Post-operatively painful defecation was observed in all patients, wound infection in 36, scanty bleeding and diaper staining in 25, constipation in 20 and recurrent rectal prolapse in 6 patients. Conclusion: Surgical treatment of rectal prolapse by Thiersch stitch is simple to perform and has less complications.

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Background: Rectal prolapse is a common pediatric surgical problem with many treatment options. This study was conducted to assess the outcome of Thiersch stitch in the management of rectal prolapse in children. Methodology: It was a descriptive study conducted at Department of Pediatric Surgery, Lady Reading Hospital Peshawar from January 2003 to December 2008. Patients with complete rectal prolapse for more than 3 months were included. Patients were admitted 24 hours before the procedure. Kleen enema was given in the morning of operation. The procedure was performed under general anaesthesia. Vicryl size 1 was wrapped around the lower part of anal canal subcutaneously. Patients were discharged home on same day on oral analgesics for a week and laxatives for a month. They were followed in outpatient department for 3 months and any complication was recorded. Results: Sixty-five patients, 37 males and 28 females, with complete rectal prolapse were operated. Age range was 2-8 years. No complication was seen during operation. Post-operatively painful defecation was observed in all patients, wound infection in 36, scanty bleeding and diaper staining in 25, constipation in 20 and recurrent rectal prolapse in 6 patients. Conclusion: Surgical treatment of rectal prolapse by Thiersch stitch is simple to perform and has less complications.

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Available abstract

Background: Rectal prolapse is a common pediatric surgical problem with many treatment options. This study was conducted to assess the outcome of Thiersch stitch in the management of rectal prolapse in children. Methodology: It was a descriptive study conducted at Department of Pediatric Surgery, Lady Reading Hospital Peshawar from January 2003 to December 2008. Patients with complete rectal prolapse for more than 3 months were included. Patients were admitted 24 hours before the procedure. Kleen enema was given in the morning of operation. The procedure was performed under general anaesthesia. Vicryl size 1 was wrapped around the lower part of anal canal subcutaneously. Patients were discharged home on same day on oral analgesics for a week and laxatives for a month. They were followed in outpatient department for 3 months and any complication was recorded. Results: Sixty-five patients, 37 males and 28 females, with complete rectal prolapse were operated. Age range was 2-8 years. No complication was seen during operation. Post-operatively painful defecation was observed in all patients, wound infection in 36, scanty bleeding and diaper staining in 25, constipation in 20 and recurrent rectal prolapse in 6 patients. Conclusion: Surgical treatment of rectal prolapse by Thiersch stitch is simple to perform and has less complications.

Key concepts: Medicine, Rectal prolapse, Surgery, Constipation, Complication, Enema, Defecation, Proctoscopy

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