Espinoza-Méndez A, Rodríguez FE, Aguirre-Jáuregui OM, Gutiérrez-Ureña R, Medina-Andrade MA, Angulo-Castellanos E, Orozoco-Pérez JA

Language: Spanish
References: 17
Page: 105-110
PDF size: 561.65 Kb.

ABSTRACT

Introduction: The rectal prolapse presents itself frequently in childhood. In most of the cases, it is secondary to other pathologies like cystic fibrosis, constipation, diarrhea, parasitosis, malnutrition, polyps, myelomeningocele, etc. The surgical treatment is reserved for refractory cases to medical handling.
Objective: To show our experience on the handling of rectal prolapse with a simplified technique through a laparoscopic approach.
Material and methods: We performed a retrospective analysis on those patients who persisted with rectal prolapse after a conservative handling and two sessions of sclerotherapy treated though laparoscopic approach. Technique: Umbilical approach, 5mm telescope, 5 mm right and left pararectal trocar, the rectum is cephalically pulled, rectopexy to the sacrum promontory peritoneum with 3 stitches? Separated with silk on each side of the rectum.
Results: 10 patients were intervened, mean age 4.8, 8 without concomitant pathologies, one with myelomeningocele surgery background and one with persistent constipation. Only the patient with myelomeningocele had a relapse. No complication were registered, the hospital stay was 3.4 on average and there was no relapse on a maximum of 5 years and a minimal of 7 months.
Discussion: The rectopexy is a preferred technique for many surgeons, either perineal via, sagittal posterior or abdominal, with placement of meshes or prosthetics, and with or without reconstruction of the pelvic surface. In our experience, the rectopexy to the sacrum peritoneum offers the same results with fewer complications and its use thought the laparocospy turns it in the most simple method for the relapse treatment in this via.

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