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. 2024 Nov 12;24(1):354.
doi: 10.1186/s12893-024-02653-3.

Ethanol sclerotherapy in pediatric rectal prolapse: efficacy, complications, and influencing factors

Mehdi Forooghi  1   2 , Fateme Ziyaee  3 , Hamidreza Foroutan  2 , Ali Bahador  2 , Ali Tadayon  2 , Omidreza Azh  2 , Maryam Ranjbar  4 , Pardis Bostanian  4 , Sara Mostafavi  4 , Sina Jamzad  4 , Amir Mohammad Ghiasi Nezhad  4 , Narges Ansary  1 , Mahsa Rouhafshari  1 , Mohammadreza Khazaie  4 , Hossein Fatemian  5 , Rezvan Moradi  4
Affiliations

Ethanol sclerotherapy in pediatric rectal prolapse: efficacy, complications, and influencing factors

Mehdi Forooghi et al. BMC Surg. .

Abstract

Introduction: Rectal prolapse is prevalent in children and the elderly, impacting quality of life significantly. Traditional surgical interventions carry risks, especially in pediatric patients. Ethanol sclerotherapy offers a less invasive alternative, inducing fibrosis and thickening of the rectal wall. Despite its potential benefits, procedural complications are possible, emphasizing the need for careful patient selection and procedural expertise. This study aims to evaluate the safety and efficacy of sclerotherapy in treating rectal prolapse in a tertiary referral center in southern Iran.

Methods: Patient records from Nemazee Hospital covering January 2014 to December 2023 were retrospectively analyzed. Pediatric patients undergoing ethanol sclerotherapy for rectal prolapse were included. Data on demographics, presentation, procedures, and outcomes were collected. Ethical approval was obtained, and specific inclusion/exclusion criteria were applied. Statistical analyses were conducted using SPSS version 26.

Results: One hundred thirty patients were evaluated, with a mean age of 10.74 ± 5.320 years. Most patients experienced constipation (56.9%). 74.2% responded well to sclerotherapy, with 12.9% needing a second injection. Complications were minimal, with bleeding being the most common (4.6%). Recurrence occurred in 18.6% of cases. Male patients showed a higher total complication rate (P = 0.010). Diarrhea-dominant patients had no recurrences post-sclerotherapy. Age significantly influenced treatment response and recurrence (P = 0.017, P = 0.035).

Conclusion: Male predominance contradicted global pediatric rectal prolapse ratios, possibly influenced by cultural factors. Sclerotherapy remains effective, though response rates vary. Older age correlated with lower response rates and higher recurrence. Constipation-dominant prolapse was associated with increased recurrence risk. Male patients had a higher complication rate, highlighting the need for tailored management strategies.

Keywords: Ethanol sclerotherapy; Pediatric; Rectal prolapse.

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Conflict of interest statement

Declarations Ethics approval and consent to participate We made sure to secure ethical approval from the Shiraz University of Medical Sciences Institutional Review Board by the ethical approval code of IR.SUMS.MED.REC.1402.471. Consent for publication Not applicable. Competing interests The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Ethanol sclerotherapy procedure. Photographs of the ethanol sclerotherapy procedure, illustrating the technique and patient positioning during the intervention
Fig. 2
Fig. 2
Ethanol sclerotherapy setup. This image depicting the setup and equipment used for ethanol sclerotherapy
See this image and copyright information in PMC

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