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01-08-2020 | Posterior Sagittal Anorectoplasty | Original Article

Long-term follow-up for anorectal function after anorectoplasty in patients with high/intermediate imperforate anus: a single center experience

Authors: Toshiaki Takahashi, Koji Fukumoto, Masaya Yamoto, Kengo Nakaya, Akinori Sekioka, Akiyoshi Nomura, Yutaka Yamada, Naoto Urushihara

Published in: Surgery Today | Issue 8/2020

Abstract

Purpose

The aim of this study was to evaluate the clinical outcomes and postoperative anorectal function in the patients with high/intermediate imperforate anus (HIA/IIA) treated in our institution. In addition, we report our novel procedure, laparoscopically assisted anorectoplasty with anterior perineal incision (LAARP-API), which allows direct approach to the anterior edge of the puborectal sling and muscle complex, and is useful for the creation of a pulling-through route for the rectal pouch.

Methods

From 1976 to 2016, 22 patients with HIA and 43 patients with IIA underwent sacroperineal/sacroabdominoperineal pull-through anorectoplasty (SP/SAP), Potts procedure (Potts), SP with API (SP-API) or LAARP-API. Clinical data and anorectal function of those patients were retrospectively evaluated using the Japanese clinical score.

Results

Of the 22 cases of HIA, 15 were treated by SAP, 2 were SP and 5 were LAARP-API. Of the 43 cases of IIA, one was treated by SAP, 31 were SP, two were Potts and nine were SP-API. The mean score of anorectal function of HIA/IIA both increased with age. In IIA, the score after SP-API was significantly higher than the score after SP.

Conclusion

Long-term outcomes of our anorectoplasty for HIA/IIA are good with excellent anorectal function score.

Santulli TV. The treatment of imperforate anus and associated fistulas. Surg Gynecol Obstet. 1952;95:601–14.PubMed

Dubreuilh M. Case of imperforate anus, with absence of the rectum, in which the colon opened into the superior fundus of the bladder. Prov Med Surg J. 1840;2(46):397.

Pena A, Devries PA. Posterior sagittal anorectoplasty: Important technical considerations and new applications. J Pediatr Surg. 1982;17:796–811.CrossRef

deVries PA, Pena A. Posterior sagittal anorectoplasty. J Pediatr Surg. 1982;17:638–43.CrossRef

Georgeson KE, Inge TH, Albanese CT. Laparoscopically assisted anorectal pull-through for high imperforate anus: a new technique. J Pediatr Surg. 2000;35:927–31.CrossRef

Kudou S, Iwanaka T, Kawashima H. Midterm follow-up study of high-type imperforate anus after laparoscopically assisted anorectoplasty. J Pediatr Surg. 2005;40:1923–6.CrossRef

Ichijo C, Kaneyama K, Hayashi Y, Koga H, Okazaki T, Yamataka A, et al. Midterm postoperative clinicoradiologic analysis of surgery for high/intermediate-type imperforate anus: Prospective comparative study between laparoscopy-assisted and posterior sagittal anorectoplasty. J Pediatr Surg. 2008;43:158–62.CrossRef

Lima M, Antonellini C, Ruggeri G. Laparoscopic surgical treatment of anorectal malformations. Pediatr Med Chir. 2006;28:79–82.PubMed

Bischoff A, Martinez-Leo B, Pena A. Laparoscopic approach in the management of anorectal malformations. Pediatr Surg Int. 2015;31:431–7.CrossRef

10.

Stephens FD, Smith ED. Ano-rectal malformations in children. Chicago: Year Book Medical Publishers; 1971.

11.

Yamada R, Nishi S, Yamamoto H. High imperforate anus-Anterior perineal approach in sacroperineal anorectoplasty. Shyoni-geka. 1990;22:527–32.

12.

Stephens FD, Smith ED, Paoul NW. Ano-rectal malformations in Children: update 1988. Birth Defect. 1988;24:177–207.

13.

Van der Zee DC, Dik P, Beek FJ. Laparoscopy-assisted anorectal pull-through in anorectal malformations: a reappraisal. World J Surg. 2013;37:1934–9.CrossRef

14.

Shawyer AC, Livingston MH, Cook DJ, Braga LH. Laparoscopic versus open repair of recto-bladderneck and recto-prostatic anorectal malformations: a systematic review and mata-analysis. Pediatr Surg Int. 2015;31:17–30.CrossRef

15.

England RJ, Warren SL, Bezuidenhout L, Numanoglu A, Millar AJ. Laparoscopic repair of anorectal malformations at the Red Cross War Memorial Children’s Hospital: Taking stock. J Pediatr Surg. 2012;47:565–70.CrossRef

16.

Georgeson K. Laparoscopic assited anorectal pull-through. Semin Pediatr Surg. 2007;16:266–9.CrossRef

Title: Long-term follow-up for anorectal function after anorectoplasty in patients with high/intermediate imperforate anus: a single center experience
Authors: Toshiaki Takahashi
Koji Fukumoto
Masaya Yamoto
Kengo Nakaya
Akinori Sekioka
Akiyoshi Nomura
Yutaka Yamada
Naoto Urushihara
Publication date: 01-08-2020
Publisher: Springer Singapore
Keywords: Posterior Sagittal Anorectoplasty
Incision
Published in: Surgery Today / Issue 8/2020
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-020-01973-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Long-term follow-up for anorectal function after anorectoplasty in patients with high/intermediate imperforate anus: a single center experience

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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