Modified Gant–Miwa approach versus modified Thiersch’s stitch for the management of rectal mucosal prolapse in children: how to decrease recurrence?

Purposes The aim of this study was to assess the early outcomes and advantages of a modified Gant–Miwa approach for the treatment of rectal mucosal prolapse in children and determine howthis modification helps decrease recurrence when compared with modified Thiersch’s stitchin a prospective and randomized setting.BackgroundRecurrence of rectal mucosal prolapse after rectal mucosal prolapse repair through the anusrepresents a problem for the surgeon and the patient. Although there are many trials to preventthis recurrence, a definite solution has not been found yet.Patients and methodsThe study included 60 children with rectal mucosal prolapse (mean age 3.6 ± 1.2 years)who were divided into two groups: group A (N = 30), comprising patients who underwent the modified Gant–Miwa operation, and group B (N = 30), comprising patients who underwent amodified Thiersch’s prolene stitch.ResultsThe modified Gant–Miwa operation was a successful approach with which to decrease constipation [2.0 (6.6%) vs. 9.0 (30%) cases; P 0.05] and recurrence [1.0 (3.3%) vs. 5(16.6%); P = 0.0002] to a great extent, although it was followed by more anal soiling in thefi rst 2 weeks (11.3 ± 0.7 vs. 3.7 ± 0.2; P 0.05).Conclusion The modified Gant–Miwa operation was a successful approach for decreasing early postoperative morbidity, especially constipation and recurrence, and thus incidences of surgicalredo because of complications were also fewer, despite it being associated with more analdischarge especially in the first 2 weeks.