当前位置： SCI文献检索 > PEDIATRIC SURGERY INTERNATIONAL期刊下所有文献 > Long-term outcomes and complications after laparoscopic-assisted anorectoplasty vs. posterior sagittal anorectoplasty for high- and intermediate-type anorectal malformation.

Long-term outcomes and complications after laparoscopic-assisted anorectoplasty vs. posterior sagittal anorectoplasty for high- and intermediate-type anorectal malformation.

Abstract：

PURPOSE:Laparoscopic-assisted anorectoplasty (LAARP) is a minimally invasive procedure in which the levator ani muscle is left to potentially improve postoperative fecal continence. This study aimed to retrospectively evaluate postoperative complications and long-term outcomes of fecal continence after LAARP and compare them to those after posterior sagittal anorectoplasty (PSARP). METHODS:Forty-five male patients with high and intermediate anorectal malformation (aged ≥ 4 years) who underwent LAARP or PSARP (LAARP 29, PSARP 16) from 1999 to 2013 were included. Postoperative complications and postoperative fecal continence were retrospectively evaluated and compared. Postoperative complications were also compared before and after introducing a urethroscope during fistula resection. RESULTS:Complications after LAARP and PSARP were seen in 12 vs. 2 cases (p = 0.09) of mucosal prolapse and in 9 vs. 1 case (p = 0.07) of posterior urethral diverticulum (PUD), respectively. The incidence of PUD decreased after introduction of a urethroscopy from 40% in 8/20 cases to 11% in 1/9 cases. No significant difference was found in terms of fecal continence in both groups. CONCLUSION:Through our study, greater improvement of postoperative fecal continence after LAARP has not been shown. LAARP was at higher risk for mucosal prolapse and PUD. However, precise dissection of the urethral fistula could be performed after the introduction of urethroscopy.

journal_name

Pediatr Surg Int

journal_title

Pediatric surgery international

authors

Tainaka T,Uchida H,Tanaka Y,Hinoki A,Shirota C,Sumida W,Yokota K,Makita S,Oshima K,Chiba K,Ishimaru T,Kawashima H

doi

10.1007/s00383-018-4323-4

subject

Has Abstract

pub_date

2018-10-01 00:00:00

pages

1111-1115

issue

10

eissn

0179-0358

issn

1437-9813

pii

10.1007/s00383-018-4323-4

journal_volume

34

pub_type

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