A novel laparoscopic technique for anorectal malformation with low recto-bulbar fistulae

Mei Diao, Long Li, Kao Ping Guan, Zhen Zhang, Wei Cheng

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: The repair of anorectal malformation (ARM) with low recto-bulbar fistula (bowel-to-skin distance: 1–1.5 cm) is contraindicated for laparoscopy due to the difficulty in exposing the fistulae. Posterior or anterior sagittal anorectoplasty is thus conventionally carried out for low recto-bulbar fistula repair. However, these procedures carry the potential risk of wound infection/dehiscence and incontinence. We have developed a single-incision laparoscopic-assisted perineal anorectoplasty (SILPARP) technique. The current study aims to evaluate the safety and efficacy of this novel procedure. Methods: Fifteen infants with ARMs and low recto-bulbar fistulae who underwent a SILPARP between November 2013 and March 2016 were reviewed. Results: The mean distance between the rectal pouch and the perineal skin was 1.15 cm. The mean age at the time of surgery was 3.92 months. The average operative time was 1.60 h. All patients resumed feeding on postoperative day 1. The median follow-up duration was 7 months. No injury to blood vessels, the urethra or vas deferens was encountered in our series. No mortality, morbidity of wound infection, rectal retraction, anal stenosis, or rectal prolapse was encountered. The postoperative voiding cystourethrogram verified that there was no urethral diverticulum or recurrent fistula. Postoperative pelvic magnetic resonance imaging demonstrated that the distal rectum was located in the center of the pelvic muscle complex. Conclusions: SILPARP is a feasible alternative treatment for ARM infants with low recto-bulbar fistulae.

Original languageEnglish
Pages (from-to)4326-4330
Number of pages5
JournalSurgical Endoscopy
Volume31
Issue number10
DOIs
Publication statusPublished - Oct 2017

Keywords

  • Anorectal malformation
  • Anorectoplasty
  • Children
  • Laparoscopy
  • Low recto-bulbar fistula

Cite this

Diao, Mei ; Li, Long ; Guan, Kao Ping ; Zhang, Zhen ; Cheng, Wei. / A novel laparoscopic technique for anorectal malformation with low recto-bulbar fistulae. In: Surgical Endoscopy. 2017 ; Vol. 31, No. 10. pp. 4326-4330.
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abstract = "Background: The repair of anorectal malformation (ARM) with low recto-bulbar fistula (bowel-to-skin distance: 1–1.5 cm) is contraindicated for laparoscopy due to the difficulty in exposing the fistulae. Posterior or anterior sagittal anorectoplasty is thus conventionally carried out for low recto-bulbar fistula repair. However, these procedures carry the potential risk of wound infection/dehiscence and incontinence. We have developed a single-incision laparoscopic-assisted perineal anorectoplasty (SILPARP) technique. The current study aims to evaluate the safety and efficacy of this novel procedure. Methods: Fifteen infants with ARMs and low recto-bulbar fistulae who underwent a SILPARP between November 2013 and March 2016 were reviewed. Results: The mean distance between the rectal pouch and the perineal skin was 1.15 cm. The mean age at the time of surgery was 3.92 months. The average operative time was 1.60 h. All patients resumed feeding on postoperative day 1. The median follow-up duration was 7 months. No injury to blood vessels, the urethra or vas deferens was encountered in our series. No mortality, morbidity of wound infection, rectal retraction, anal stenosis, or rectal prolapse was encountered. The postoperative voiding cystourethrogram verified that there was no urethral diverticulum or recurrent fistula. Postoperative pelvic magnetic resonance imaging demonstrated that the distal rectum was located in the center of the pelvic muscle complex. Conclusions: SILPARP is a feasible alternative treatment for ARM infants with low recto-bulbar fistulae.",
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A novel laparoscopic technique for anorectal malformation with low recto-bulbar fistulae. / Diao, Mei; Li, Long; Guan, Kao Ping; Zhang, Zhen; Cheng, Wei.

In: Surgical Endoscopy, Vol. 31, No. 10, 10.2017, p. 4326-4330.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - A novel laparoscopic technique for anorectal malformation with low recto-bulbar fistulae

AU - Diao, Mei

AU - Li, Long

AU - Guan, Kao Ping

AU - Zhang, Zhen

AU - Cheng, Wei

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N2 - Background: The repair of anorectal malformation (ARM) with low recto-bulbar fistula (bowel-to-skin distance: 1–1.5 cm) is contraindicated for laparoscopy due to the difficulty in exposing the fistulae. Posterior or anterior sagittal anorectoplasty is thus conventionally carried out for low recto-bulbar fistula repair. However, these procedures carry the potential risk of wound infection/dehiscence and incontinence. We have developed a single-incision laparoscopic-assisted perineal anorectoplasty (SILPARP) technique. The current study aims to evaluate the safety and efficacy of this novel procedure. Methods: Fifteen infants with ARMs and low recto-bulbar fistulae who underwent a SILPARP between November 2013 and March 2016 were reviewed. Results: The mean distance between the rectal pouch and the perineal skin was 1.15 cm. The mean age at the time of surgery was 3.92 months. The average operative time was 1.60 h. All patients resumed feeding on postoperative day 1. The median follow-up duration was 7 months. No injury to blood vessels, the urethra or vas deferens was encountered in our series. No mortality, morbidity of wound infection, rectal retraction, anal stenosis, or rectal prolapse was encountered. The postoperative voiding cystourethrogram verified that there was no urethral diverticulum or recurrent fistula. Postoperative pelvic magnetic resonance imaging demonstrated that the distal rectum was located in the center of the pelvic muscle complex. Conclusions: SILPARP is a feasible alternative treatment for ARM infants with low recto-bulbar fistulae.

AB - Background: The repair of anorectal malformation (ARM) with low recto-bulbar fistula (bowel-to-skin distance: 1–1.5 cm) is contraindicated for laparoscopy due to the difficulty in exposing the fistulae. Posterior or anterior sagittal anorectoplasty is thus conventionally carried out for low recto-bulbar fistula repair. However, these procedures carry the potential risk of wound infection/dehiscence and incontinence. We have developed a single-incision laparoscopic-assisted perineal anorectoplasty (SILPARP) technique. The current study aims to evaluate the safety and efficacy of this novel procedure. Methods: Fifteen infants with ARMs and low recto-bulbar fistulae who underwent a SILPARP between November 2013 and March 2016 were reviewed. Results: The mean distance between the rectal pouch and the perineal skin was 1.15 cm. The mean age at the time of surgery was 3.92 months. The average operative time was 1.60 h. All patients resumed feeding on postoperative day 1. The median follow-up duration was 7 months. No injury to blood vessels, the urethra or vas deferens was encountered in our series. No mortality, morbidity of wound infection, rectal retraction, anal stenosis, or rectal prolapse was encountered. The postoperative voiding cystourethrogram verified that there was no urethral diverticulum or recurrent fistula. Postoperative pelvic magnetic resonance imaging demonstrated that the distal rectum was located in the center of the pelvic muscle complex. Conclusions: SILPARP is a feasible alternative treatment for ARM infants with low recto-bulbar fistulae.

KW - Anorectal malformation

KW - Anorectoplasty

KW - Children

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