Outcome of Laparoscopic Treatment of Anorectal Malformations in Children

Operative correction of anorectal malformations (ARMs) remains a challenge in pediatric surgery. The study in the World Journal of Surgery aimed to evaluate the outcomes of laparoscopic treatment of ARM in children.

From 2007 to 2014, we performed 104 laparoscopic-assisted anorectal pull-through procedures in children with a mean age of 11.3 ± 0.4 months and ARMs. Clinical assessment, surgical durations, complications, and postoperative outcome were investigated. The mean duration of the operation was 126.5 ± 17.2 min. Mean intraoperative bleeding was 20 ± 5.7 g. Three (2.9 %) children required conversion to laparotomy. One (0.9 %) child developed a pelvic abscess, requiring an additional intervention. Three to six months after laparoscopic-assisted anorectal pull-through, 72 patients were hospitalized for stoma closure. Good functional results were achieved in 39 (54.2 %) patients. On examination of the perineum, 11 (15.3 %) patients were found to have mucosal prolapse. The circular symmetric anal reflex to tactile stimulation was confirmed in 53 (73.6 %) patients and a tactile weakened anal reflex in 5 (6.9 %) children. At the 1-year follow-up, constipation was present in nine (12.5 %) patients and soling in two (2.8 %) patients. A barium enema study performed after the operation showed good outcomes in 67 (93.1 %) patients and fair outcomes in 5 (6.9 %) patients. None had a poor outcome. Our experience confirms that laparoscopic-assisted anorectal pull-through enabled complete correction of ARM in the meanwhile avoiding damage to the rectum and anus. Also, the technique of double bipolar myostimulation of muscle complex in laparoscopic ARM might lead to these better results.

Cite this article as: Minaev, S.V., Kirgizov, I.V., Gladkyy, A. et al. World J Surg (2017) 41: 625. doi:10.1007/s00268-016-3699-3


7 Responses to “Outcome of Laparoscopic Treatment of Anorectal Malformations in Children”

  1. Igor says:

    Хорошая, работа в практической деятельности, врача детского хирурга,хирурга, педиатра. Рекомендую всем посмотреть и использовать в работе.
    #дети#хирургия#атрезия ануса#клоака

  2. Igor says:

    #children, #surgery, anorectal malformations, ARM, laparoscopy, pediatric

  3. Igor says:

    Добрый день! Скажите до какого возраста в наблюдаете за такими пациентами? И что делать если у ребёнка возникает не держание?
    #children, #surgery, anorectal malformations, ARM, laparoscopy, pediatric

    • Igor says:

      Наблюдаем как правило до 18 лет и старше. При появлении недержания в зависимости от причины недержания лечение или оперативное или консервативное

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