Abstract | PURPOSE: This study aimed to evaluate the mid-term outcomes of single-stage modified anterior sagittal anorectoplasty (ASARP) for anorectal malformation with vestibular fistula. METHOD: Twenty-six patients with congenital imperforate anus and vestibular fistula underwent single-stage modified sphincter-saving ASARP between January 2008 and December 2012. The ages of the patients at the time of operation ranged from 1 month to 5.1 years. Standard ASARP procedure was modified to avoid the incision of the external sphincter complex. Instead a potential tunnel was created through the center of external sphincter complex under the endoscopic guidance. The patients were evaluated for fecal continence and complications. RESULT: Modified ASARP was successfully performed in all patients. The mean operation time was 52.2 ± 3.5 min (range 47-61 min). The operative blood loss was minimal. There was no operative complication. Wound infection occurred in 3 patients (3/26, 11.5%). All patients were followed up for 4.2 ± 1.5 years (range 2-6 years). No patient developed fecal incontinence. Three patients (3/26, 11.5%) had soiling once or twice per week. Four patients (4/26, 15.4%) had constipation amenable to diet management. Mucosal prolapse occurred in 1 patient (1/26, 3.8%). There was no recurrence of fistula, anal stenosis or anterior displacement of the neorectum. CONCLUSION: Mid-term results show that single-stage modified ASARP is an effective and safe option for patients with anorectal malformation and congenital vestibular fistula.
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Authors | Chen Wang, Long Li, Shuli Liu, Zheng Chen, Mei Diao, Xu Li, Guoliang Qiao, Wei Cheng |
Journal | Pediatric surgery international
(Pediatr Surg Int)
Vol. 31
Issue 9
Pg. 809-14
(Sep 2015)
ISSN: 1437-9813 [Electronic] Germany |
PMID | 26129980
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Anal Canal
(abnormalities, surgery)
- Anorectal Malformations
- Anus, Imperforate
(surgery)
- Blood Loss, Surgical
(statistics & numerical data)
- Child, Preschool
- Female
- Humans
- Infant
- Male
- Operative Time
- Plastic Surgery Procedures
(methods)
- Rectal Fistula
(congenital, surgery)
- Rectum
(abnormalities, surgery)
- Surgical Wound Infection
(epidemiology)
- Treatment Outcome
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