One-stage single-incision laparoscopic-assisted anorectoplasty for newborns with anorectal malformations and recto-urethral fistula
- Author:
- No author available
- Journal Title:
- Chinese Journal of Pediatric Surgery
- Issue:
- 9
- DOI:
- 10.3760/cma.j.issn.0253-3006.2017.09.003
- Key Word:
- 腹腔镜治疗;肛门闭锁;直肠尿道瘘;Therapeutic laparoscopy;Imperforate anus;Recto-urethral fistula
Abstract： Objective Currently staged procedures involving stoma formation and closure are the widely accepted for treating newborns with anorectal malformations (ARMs) and recto-urethral fistula.This study was intended to evaluate the safety and efficacy of one-stage single-incision laparoscopic-assisted anorectoplasty (SILAARP) as an alternative to the conventional approach.Methods Newborns with ARMs and recto-urethral fistula undergoing one-stage SILAARP between June 2013 and December 2015 were reviewed.The procedure involved decompressing meconiurn via a small temporary incision of proximal sigrnoid colon followed by laparoscopic-assisted pull-through.Results Sixteen ARM newborns successfully underwent one-stage SILAARP for recto-prostatic fistula (n =8) and recto-bulbar fistula (n =14).The mean operative age was 42.1 hours and the average operative duration was 2.4 hours.The actual pull-though time did not differ significantly from that during pull-through procedure of 3-stage control group (1.7 vs 1.9 hours).No complications occurred during a median follow-up period of 18 (3-33) months.Postoperative pelvic magnetic resonance imaging confirmed the centrally placed rectum within muscle complex.Twenty patients started bowel movements at Day 1 post-birth.Two constipated patients periodically required an enema for 1-3 months.Conclusions One-stage SILAARP is both safe and effective.It provides complete rectification of ARM and recto-urethral fistula with an excellent cosmesis.
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