■虽然在成年人口中更常见,直肠脱垂是一种常见的肛门直肠疾病,可发生在儿童和青少年。虽然许多病例无需干预即可自发解决,较新的微创手术和手术的出现为儿科患者提供了选择.这里,我们回顾了病理生理学,病因学,介绍,在过去的几十年中,儿科人群直肠脱垂的诊断和治疗原则已经发展。
■这些文献是从免费数据库中查询的,这些数据库可供公众使用,包括美国国立卫生研究院国家医学图书馆MEDLINE和PubMed,以获取1975年1月1日至2023年12月1日出版的手稿。没有随附英语翻译的手稿或完全用外语编写的手稿被排除在外。
■许多情况导致儿童直肠脱垂,包括便秘,胃肠道感染性和非感染性病因,囊性纤维化,营养不良,神经性,解剖,领先点,和虐待。直肠脱垂的初始管理是医学管理,解决与直肠脱垂相关的潜在疾病,并尝试手动复位。对于复发性直肠脱垂的患者,除了通过开放和较新的微创方法进行手术直肠固定术外,还提供了多种非侵入性和程序性管理选择,包括注射硬化疗法和肛门包围。
■尽管评估取得了重大进展,在过去的几十年中,儿科肛肠疾病的程序和手术管理,在儿童和青少年直肠脱垂的治疗中,临床医生和外科医生的实践仍然存在很大差异。未来仍有许多研究要改善该患者群体的临床结果。
UNASSIGNED: Although more frequent in the adult population, rectal prolapse is a common anorectal condition that can occur in children and adolescents. While many cases spontaneously resolve without the need for intervention, the advent of newer minimally invasive procedures and operations have provided options for pediatric patients. Here, we review the pathophysiology, etiology, presentation, diagnosis and principles of management of rectal prolapse in the pediatric population as it has evolved over the past several decades.
UNASSIGNED: The literature was queried from free databases available to the public including the National Institute of Health National Library of Medicine MEDLINE and PubMed for manuscripts published from January 1, 1975 to December 1, 2023. Manuscripts without an accompanying English translation or those written entirely in foreign languages were excluded.
UNASSIGNED: Numerous conditions contribute to rectal prolapse in children, including constipation, gastrointestinal infectious and non-infectious etiologies, cystic fibrosis, malnutrition, neurogenic, anatomic, lead points, and abuse. Initial management of rectal prolapse is medical management, addressing the underlying condition associated with rectal prolapse along with attempted manual reduction. For patients with recurrent rectal prolapse, a variety of noninvasive and procedural management options are available including injection sclerotherapy and anal encirclement in addition to surgical rectopexy by open and newer minimally invasive methods.
UNASSIGNED: Despite significant advances in the evaluation, procedural and surgical management of pediatric anorectal conditions in the last few decades, there continues to be substantial variation in clinicians\' and surgeons\' practice for the treatment of rectal prolapse in children and adolescents. Much remains to be studied in the future to improve clinical outcomes for this patient population.