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Single-incision laparoscopic-assisted anorectoplasty for treating children with intermediate-type anorectal malformations and rectobulbar fistula: a comparative study

  • Xianghai Ren
  • Hang Xu
  • Qi Jiang
  • Mei Diao
  • Xu Li
  • Long LiEmail author
Original Article
  • 33 Downloads

Abstract

Purpose

Single-incision laparoscopic-assisted anorectoplasty (SILAARP) was compared to posterior sagittal anorectoplasty (PSARP) for treating intermediate-type anorectal malformations (ARMs) with rectobulbar fistula.

Methods

Between December 2011 and January 2016, 48 children with intermediate-type ARMS were treated with SILAARP (n = 34) or PSARP (n = 14) in our centre. Data including demographics, complications, and long-term outcomes were retrospectively compared.

Results

No significant difference was observed between both groups in terms of median operative time and complications. The length of postoperative hospital stay was shorter in the SILAARP group than in the PSARP group (6.15 ± 1.10 vs 9.64 ± 4.13 days; p = 0.008). After a mean follow-up of 59.38 ± 13.68 months, the rates of voluntary bowel movements, soiling, and constipation were similar in both groups. Anorectal manometry was performed in 15 and 7 children from the SILAARP and PSARP groups, respectively. Although there were no significant differences in the presence of rectoanal relaxation reflex and high-pressure-zone length, anal canal resting pressure was higher in the SILAARP group than in the PSARP group (33.35 ± 12.95 vs 23.06 ± 8.40 mmHg; p = 0.039).

Conclusions

Both SILAARP and PSARP seemed feasible and effective for treating intermediate-type ARMs with rectobulbar fistula in children. However, SILAARP significantly reduced the length of postoperative hospital stay and improved anal canal resting pressure.

Keywords

Laparoscopy-assisted anorectoplasty Posterior sagittal anorectoplasty Anorectal malformations Levator ani Terminal rectum 

Notes

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to disclose.

Research involving human participants

Ethical approval was obtained from the Ethics Committee of the Capital Institute of Pediatrics.

Informed consent

Written informed consents were obtained from the parents before anorectoplasty.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Xianghai Ren
    • 1
    • 2
  • Hang Xu
    • 2
  • Qi Jiang
    • 3
  • Mei Diao
    • 2
  • Xu Li
    • 2
  • Long Li
    • 1
    • 2
    Email author
  1. 1.Graduate School of Peking Union Medical CollegeChinese Academy of Medical SciencesBeijingPeople’s Republic of China
  2. 2.Department of Pediatric SurgeryCapital Institute of PediatricsBeijingPeople’s Republic of China
  3. 3.Department of Pathology and Pathophysiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, School of Basic Medical SciencesWuhan UniversityWuhanPeople’s Republic of China

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