Transanal rectal mucosectomy and muscular plication: A new technique for rectal prolapse in patients with an anorectal malformation

J Pediatr Surg. 2020 Nov;55(11):2531-2535. doi: 10.1016/j.jpedsurg.2020.05.025. Epub 2020 May 29.

Abstract

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.

Keywords: Anorectal malformation; Imperforate anus; Rectal muscular plication; Rectal prolapse; Transanal rectal mucosectomy.

MeSH terms

  • Anal Canal / surgery
  • Anorectal Malformations* / surgery
  • Child
  • Humans
  • Laparoscopy*
  • Postoperative Complications / surgery
  • Rectal Prolapse* / complications
  • Rectal Prolapse* / surgery
  • Rectum / surgery
  • Retrospective Studies