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World Journal of Surgery

, Volume 41, Issue 2, pp 625–629 | Cite as

Outcome of Laparoscopic Treatment of Anorectal Malformations in Children

  • Sergey V. Minaev
  • Igor V. Kirgizov
  • Aleksander Gladkyy
  • Ilya Shishkin
  • Igor Gerasimenko
Original Scientific Report

Abstract

Background

Operative correction of anorectal malformations (ARMs) remains a challenge in pediatric surgery. The study aimed to evaluate the outcomes of laparoscopic treatment of ARM in children.

Methods

From 2007 to 2014, we performed 104 laparoscopic-assisted anorectal pull-through procedures in children with a mean age of 11.3 ± 0.4 months and ARMs. Clinical assessment, surgical durations, complications, and postoperative outcome were investigated.

Results

The mean duration of the operation was 126.5 ± 17.2 min. Mean intraoperative bleeding was 20 ± 5.7 g. Three (2.9 %) children required conversion to laparotomy. One (0.9 %) child developed a pelvic abscess, requiring an additional intervention. Three to six months after laparoscopic-assisted anorectal pull-through, 72 patients were hospitalized for stoma closure. Good functional results were achieved in 39 (54.2 %) patients. On examination of the perineum, 11 (15.3 %) patients were found to have mucosal prolapse. The circular symmetric anal reflex to tactile stimulation was confirmed in 53 (73.6 %) patients and a tactile weakened anal reflex in 5 (6.9 %) children. At the 1-year follow-up, constipation was present in nine (12.5 %) patients and soling in two (2.8 %) patients. A barium enema study performed after the operation showed good outcomes in 67 (93.1 %) patients and fair outcomes in 5 (6.9 %) patients. None had a poor outcome.

Conclusions

Our experience confirms that laparoscopic-assisted anorectal pull-through enabled complete correction of ARM in the meanwhile avoiding damage to the rectum and anus. Also, the technique of double bipolar myostimulation of muscle complex in laparoscopic ARM might lead to these better results.

Keywords

Anal Canal Anorectal Malformation Urethral Diverticulum Mucosal Prolapse Barium Enema Study 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The authors acknowledge the help supplied by Prof. Gian Battista Parigi (Italy) and Prof. Paul KH Tam (Hong Kong), in the preparation of the manuscript.

Compliance with ethical standards

Conflict of interest

Drs. Sergey Minaev, Igor Kirgizov, Aleksandr Gladkiy, Ilya Shishkin, and Igor Gerasimenko have no conflicts of interest or financial ties to disclose.

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Copyright information

© Société Internationale de Chirurgie 2016

Authors and Affiliations

  • Sergey V. Minaev
    • 1
  • Igor V. Kirgizov
    • 2
  • Aleksander Gladkyy
    • 3
  • Ilya Shishkin
    • 2
  • Igor Gerasimenko
    • 1
  1. 1.Department of Pediatric SurgeryStavropol State Medical UniversityStavropolRussian Federation
  2. 2.Department of Pediatric SurgeryCentral Clinical Hospital of the Presidential Administration of the Russian FederationMoscowRussian Federation
  3. 3.Department of Pediatric SurgeryRegional Children HospitalDnepropetrovskUkraine

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