title: Successful treatment of recurrent rectal prolapse using three Thiersch sutures in children.
abstract: Many techniques are described to manage recurrent rectal prolapse in children, including repeated Thiersch stitch, phenol injections, Delorme and Altemeier procedures, and rectopexy. We describe a case of successful treatment of rectal prolapse by placing three Thiersch sutures circumferentially along the anal canal--a simple and novel modification of a well-known procedure. An 8-year-old boy with full-thickness rectal prolapse was treated with laxatives to no avail. He was subsequently treated with phenol-in-almond-oil injection and insertion of a 1/0PDS Thiersch suture. The effects were temporary with recurrence 3 months later. A further phenol-in-almond-oil injection was given and a 1/0PDS Thiersch suture placed, and the patient was discharged on laxatives. Recurrence occurred again at 3 months. This was treated with three circumferential Thiersch sutures along the anal canal--one Prolene 2/0 and two 1/0PDS. There has been no recurrence at follow-up. Placement of three sequential Thiersch sutures along the rectum is effective in treating recurrent rectal prolapse and a good alternative to major rectopexy.
authors.affiliation: Department of Paediatric Surgery, Queen's Medical Campus, Nottingham, UK.
authors.forename: Kashif
authors.identifier: http://orcid.org/0000-0003-2873-0884
authors.initials: K
authors.lastname: Chauhan
authors.affiliation: Queen's Medical Centre, Nottingham, UK.
authors.forename: Richard Wei Chern
authors.identifier: http://orcid.org/0000-0002-9383-0374
authors.initials: RW
authors.lastname: Gan
authors.affiliation: Department of Paediatric Surgery, Queen's Medical Campus, Nottingham, UK.
authors.forename: Shailinder
authors.initials: S
authors.lastname: Singh
mesh_terms: D001003:Anal Canal / Q000601:surgery*; D002648:Child; D006801:Humans; D008297:Male; D012005:Rectal Prolapse / Q000601:surgery* / Q000628:therapy; D012007:Rectum / Q000601:surgery*; D012008:Recurrence; D015911:Sclerotherapy; D013536:Suture Techniques; D016896:Treatment Outcome