Laparoscopy-Assisted Anorectal Pull-Through

Abstract

Posterior sagittal anorectoplasty (PSARP) is the current standard surgical management for patients with anorectal malformations (ARM). Despite the excellent exposure of the anatomy and the exact placement of the distal rectum within the muscle complex with this operation, postoperative fecal continence is less than ideal. Tsuji et al. reported a careful analysis of postoperative anorectal function, comparing PSARP with older, conventional operations. They found that patients in both groups had a similar manometry and long-term function. Most of the patients needed bowel management. Other authors have reported similar findings. Increased constipation after PSARP compared to a more limited surgical approach has also been reported.