Preliminary Results of Laparoscopic Assisted Transanal Proximal Rectosigmoidectomy Combined With Malone Antegrade Continence Enema for the Management of Intractable Functional Constipation in Children

Al-Azhar University

Status and phase: Completed; Phase 4

Conditions: Functional Constipation in Children

Treatments: Procedure: laparoscopic assisted transanal proximal rectosigmoidectomy

Study type: Interventional

Funder types: Other

Identifiers

NCT07180680

PedSurg-38Med.Research.0000038

Details and patient eligibility

About

Technique for surgical management of intractable functional constipation

Full description

Background: Intractable functional constipation (IFC) in children poses a significant clinical challenge when standard medical interventions are unsuccessful. The laparoscopic-assisted transanal proximal rectosigmoidectomy (LATPRS) procedure is a surgical option that combines the precision of laparoscopic techniques with the functional benefits of transanal dissection.

Patients and methods: A prospective trial was conducted at Al-Azhar pediatric surgery departments from January 2022 to January 2025, with a focus on children diagnosed with IFC. Each participant underwent LATPRS combined with a Malone Antegrade continence enema (MACE). The comprehensive data collection process included patient demographics, surgical details, postoperative recovery, complications, and functional outcomes. These data were recorded and subsequently analysed. Furthermore, a validated symptom severity (SS) scoring system and the Pediatric Quality of Life Inventory (PedsQoL) were employed to assess outcomes.

Enrollment: 20 patients

Sex: All

Ages: 4 to 18 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Children aged four years or older with intractable functional constipation
2. Documented BMP failure, defined as persistent fecal impaction, chronic dependence on laxatives, or intolerance to enemas despite prolonged conservative therapy.

Exclusion criteria

1. Patients with a history of abdominal surgery or
2. Identifiable organic causes for constipation and soiling (e.g., Hirschsprung's disease, anorectal malformations, or metabolic disorders) .

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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20 participants in 1 patient group

children diagnosed with IFC

Active Comparator group

Description:

. Each participant underwent LATPRS combined with a Malone Antegrade continence enema (MACE)

Treatment:

Procedure: laparoscopic assisted transanal proximal rectosigmoidectomy