| Abstract | PURPOSE: The standard approach to males with high imperforate anus has been a staged procedure starting with a descending colostomy, then posterior sagittal anorectoplasty with colostomy closure after 3 months. Recently, a minimally invasive approach to the repair of high imperforate anus has been described in infants after colostomy. We describe 6 newborn males with high imperforate anus successfully repaired laparoscopically as a primary, single-stage procedure. METHODS: A retrospective chart review was performed on all patients with imperforate anus from October 2003 to October 2006. RESULTS: We evaluated 9 newborn males with high imperforate anus. Of these patients, 6 underwent primary laparoscopic repair on day 1 to day 2 of life. Of these 6 patients, 3 were found to have bladder neck fistulas, whereas the other 3 had prostatic urethra fistulas. All patients passed stool within the first 72 hours postoperatively. One patient has required a procedure for a mild rectal prolapse. Follow-up ranges from 2 to 30 months in the single-stage group. CONCLUSION: Our early results using primary laparoscopic repair appear encouraging. Laparoscopy allows excellent visualization and assessment of the fistula and repair of high imperforate anus without need for colostomy. Long-term follow-up will be needed to assess outcomes and continence rates. |
| Authors | Laura R Vick, John R Gosche, Scott C Boulanger, Saleem Islam
(Affiliation: Division of Pediatric Surgery, Department of Surgery, University of Mississippi Medical Center, Jackson, MS 39216, USA.)
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| Journal | Journal of pediatric surgery
(J Pediatr Surg)
Vol. 42
Issue 11
Pg. 1877-81
(Nov 2007)
ISSN: 1531-5037 United States |
| PMID | 18022439
(Publication Type: Journal Article)
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| Topics |
- Anus, Imperforate
(diagnosis, surgery)
- Child, Preschool
- Digestive System Surgical Procedures
(adverse effects, methods)
- Follow-Up Studies
- Humans
- Infant
- Infant, Newborn
- Laparoscopy
(adverse effects, methods)
- Male
- Postoperative Complications
- Rectum
(surgery)
- Retrospective Studies
- Risk Assessment
- Surgical Procedures, Minimally Invasive
(adverse effects, methods)
- Treatment Outcome
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