Long-term outcomes of male imperforate anus with recto-urethral fistula: laparoscopy-assisted anorectoplasty versus posterior sagittal anorectoplasty
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Mar 2022 · 1 min read
In brief
In brief
Comparative study of 64 male imperforate anus patients shows laparoscopy-assisted anorectoplasty (LAARP) achieves superior long-term fecal continence outcomes versus posterior sagittal anorectoplasty (PSARP), particularly for rectoprostatic fistulas. LAARP demonstrated consistently higher continence scores with less variability from 7 years postoperatively, though associated with higher anal mucosal prolapse rates.
Written by the GCMD Library team from the article.
Abstract
Purpose
A five-parameter fecal continence evaluation questionnaire (FCEQ) and incidence of complications were used for long-term assessment of laparoscopy-assisted anorectoplasty (LAARP) and posterior sagittal anorectoplasty (PSARP) for treating male imperforate anus (MIA) with rectobulbar (RB) or rectoprostatic (RP) fistulas.
Methods
Subjects were 64 consecutive Japanese MIA patients with RB or RP fistulas treated at a single institution between 1995 and 2021. FCEQ data collected retrospectively were used to calculate a fecal continence evaluation (FCE) score (best = 10) and coefficient of variation for FCE (FCECV). The statistical significance threshold was defined at p < 0.05.
Results
Fistulas were RB (n = 40; LAARP = 25/40, PSARP = 15/40) or RP (n = 24; LAARP = 17/24, PSARP = 7/24). Mean ages at surgery and status of the sacrum were similar (p = 0.06, 0.05 and 0.51). FCE scores in RP-LAARP were consistently higher with less FCECV but differences were only statistically significant from 7 years postoperatively (p < 0.05). While FCE scores for RB-LAARP and RB-PSARP were similar (p = 0.99), FCECV were lower for RB-LAARP compared with RB-PSARP. LAARP was associated with less-wound infections, but greater incidence of anal mucosal prolapse unrelated to preoperative status of the sacrum.
Conclusion
Long-term postoperative FCEQ assessment favored LAARP for treating MIA with either RB or RP fistulas.