CASES OF SURGICAL TREATMENT OF RECTAL PROLAPSE USING A MODIFIED DELORME TECHNOLOGY IN CHILDREN WITH ANORECTAL MALFORMATIONS

Rectal prolapse (RP) is one of the most expected complications following the treatment of anorectal malformations that occurs in 3.8% to 60% of cases. The main method of surgical treatment of RP is anoplasty with a recurrence rate after surgery of up to 33%. The authors describe the indications, technique and results of transanal rectal mucosectomy and muscular plication (TRMMP) proposed by Dr. Luis De La Torre-Mondragon, MD, Pediatric Colorectal Surgeon with the Children's Hospital Colorado (CHCO), Aurora, Colorado, United States, for the treatment of RP in children with anorectal malformations (AM). Materials and methods used: in a retrospective analysis of 234 patients with AM, 8 patients with RP (all males) were identified. In 2 patients, a displacement of the rectum was detected, and subsequently they underwent the posterior sagittal anorectoplasty (PSARP). Another 6 patients underwent the TRMMP. Results: all patients had previously undergone the open surgery without PSARP. The average age of patients at the time of surgery was 4.6 years (Q1-2.5, Q3-7.9; SD-2.2; min/max 2.0-5.0; 95% CI: 2.1-5.5). In all patients, the RP length averaged 2.3 cm (Q1-1.5, Q3-3.9; SD-0.9; min/max - 1.6-4.0; 95% CI: 1.4-3.3). There were no intraoperative and postoperative complications. There were no relapses of RP and stenoses of anastomoses during the dynamic follow-up after surgery for 7.6 months recorded as well (Q1-5.0, Q3-10.9; SD-2.4; min/max - 5.0-11; 95% CI: 5.1-10.2). Conclusion: the authors’ first experience confirms the efficacy of TRMMP in RP in children with AM.