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
Abstract
Arshad Kamal, Kifayat Khan, Muhammad Ahmad Khan, Younis Khan, Mohammad Uzair, M. Tariq, Mamoon ., Saddar Rahim
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.
Key concepts: Medicine, Rectal prolapse, Surgery, Constipation, Complication, Enema, Defecation, Proctoscopy