Does laparoscopic assisted anorectoplasty improve the long-term fecal continence outcomes in children with high anorectal malformations

Document Type : Original Article

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1 Department of Pediatric Surgery, Faculty of Medicine, Sohag University, Egypt.

2 Department of Pediatric Surgery, Faculty of Medicine, El Minya University, Egypt.

Abstract

Background: Anorectal malformations are a broad spectrum of anomalies with different approaches of management and variable outcomes. Aim of The Work: Our aim was to retrospectively assess the long-term fecal continence outcomes after laparoscopic-assisted anorectoplasty (LAARP) in comparison with outcomes of the classic posterior sagittal anorectoplasty (PSARP). Patients and Methods: Our study included 27 male patients with high anorectal malformations (recto-vesical, recto-bladder neck & recto-prostatic urethral fistula) whose ages were 4 years or older and have undergone LAARP or PSARP (LAARP 15, PSARP 12) in Sohag university hospital and El Minya university hospital from 2015 to 2019. Postoperative fecal continence scores were retrospectively compared. Results: Fecal continence scores were comparable between the two groups. Complications in the form of mucosal rectal prolapse occurred in 4 cases of LAARP vs. 2 cases of PSARP (p = 0.09) and posterior urethral diverticulum (PUD) occurred in 3 cases of LAARP vs. 1 case of PSARP (p = 0.07).
Conclusion: The use of LAARP didn`t give any extra benefit as regard postoperative fecal continence, on the other hand, it was associated with higher risk for mucosal prolapse and PUD.

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