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Modified Gant-Miwa Approach Versus Modified Thiersch's stitch For The Management Of Rectal Mucosal Prolapse In Children; How To Decrease The Recurrence?

• 2017
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Publication Information
Authors Taher H. Elwan, (MD); El-Sayed A. Abd El-Mabood (MD); Hazem E. Ali
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publication.type International
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Abstract
Purposes: The aim of this study was to assess the early outcomes and advantages of modified Gant-Miwa approach for the treatment of rectal mucosal prolapse in children & determine how this modification helps decrease recurrence when compared with modified Thiersch's stitch in a prospective & randomized setting.
Background: Recurrence after rectal mucosal prolapse repair through the anus represents annoying problem for the surgeon & the patient; although there are many trials to prevent this recurrence;a definite solution has not been found yet.
Patients and methods: The study included 60 children with rectal mucosal prolapse (mean age 3.6 ± 1.2 years) who were divided into 2 groups; (Group A; n= 30) comprising patients who underwent the Modified Gant-Miwa operation & (Group B; n= 30) comprising patients who underwent the Modified Thiersch's prolene stitch.
Results: Modified Gant-Miwa operation was successful approach with which to decrease constipation (2.0 (6.6%) vs 9.0 (30%) cases; P 0.05).
Conclusions: The Modified Gant-Miwa operation was a successful approach for decreasing early postoperative morbidity especially constipation & recurrence & thus incidence of Surgical Re-do because of complication was also fewer; despite it was being associated with more anal discharge especially in the first 2 weeks.
Key words: Modified Gant-Miwa Approach, Modified Thiersch’s stitch, Prolene suture, outcomes, Rectal mucosal prolapse.