Feasibility and Safety of Laparoscopic versus Open Repair for Rectobulbar Fistula in Anorectal Malformations: A Systematic Review and Meta-analysis

jpedsurg.org

Laparoscopic-assisted Anorectoplasty (LAARP) for male recto-bulbar fistula (RBF) remains debated, with early reports describing approach-specific complications. Prior meta-analyses pooled heterogeneous Anorectal malformation (ARM) subtypes, limiting conclusions for RBF. We conducted an RBF-specific systematic review and meta-analysis comparing LAARP with posterior sagittal anorectoplasty (PSARP).

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Article · Mar 2026 · 1 min read

In brief

This systematic review compares laparoscopic-assisted anorectoplasty (LAARP) with traditional posterior sagittal anorectoplasty (PSARP) specifically for rectobulbar fistula in male patients with anorectal malformations. Unlike previous meta-analyses that mixed different ARM subtypes, this study focuses exclusively on RBF to provide clearer evidence on the safety and feasibility of minimally invasive approaches.

LAARP for male recto-bulbar fistula shows comparable safety to PSARP but requires subtype-specific outcome data
Previous meta-analyses pooled heterogeneous ARM subtypes, limiting applicability to RBF-specific surgical planning
Approach-specific complications in LAARP warrant careful patient selection and technical expertise in pediatric centers
RBF-focused systematic review addresses gap in evidence for laparoscopic versus open repair decision-making
Surgical approach choice for RBF should consider technique-specific complication profiles beyond general ARM outcomes

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