Comparison of 5% Phenol With Almond Oil Versus 15% Hypertonic Saline in Treatment of Pediatric Idiopathic Rectal Prolapse.

Objective: The objective of the study was to compare the frequency of recurrence with 5% phenol in almond oil versus 15% hypertonic saline for pediatric idiopathic rectal prolapse.

Methodology:  An open-label, randomized clinical trial was conducted at the Department of Paediatric Surgery, Services Hospital, Lahore, Pakistan, over a period of one year from May 1, 2018 to April 30, 2019. Altogether, 120 patients with idiopathic rectal prolapse were included in this study. After obtaining approval from the hospital ethical committee, all patients fulfilling the inclusion criteria were admitted to the pediatric surgery inpatient department of Services Hospital, Lahore. Patients were randomized into two groups with an equal number of candidates using the lottery method. Group A consisted of patients who were administered 5% phenol in almond oil and group B consisted of patients who were administered 15% hypertonic saline. All procedures were performed by a single surgical operating team to control bias. Patients were followed up for three months after surgery to note whether recurrence occurred or not.

Results: The mean age of the patients was 3.97 ± 2.68 years in group A and 2.87 ± 1.84 years in group B. Gender distribution showed male dominance (71.7% in group A and 73.3% in group B). Statistically significant difference was observed in terms of recurrence (50% in group A and 23.3% in group B) (p=0.002), while statistically insignificant differences were found in terms of postoperative faecal incontinence (2% in each group, p=0.6478) and anal stenosis (8% in group A and 2% in group B with p=0.2426).

Conclusion: Thus, 15% hypertonic saline was noted to be a more effective sclerosing agent than 5% phenol in almond oil in the management of idiopathic rectal prolapse in children. It was also found to have a statistically comparable rate of complications, including fecal incontinence and anal stenosis.