Redo posterior sagittal anorectoplasty for lateral mislocation in patients with anorectal malformations
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Read the article on jpedsurg.org ↗Article · Jun 2020 · 1 min read
In brief
In brief
This study describes outcomes for 12 pediatric patients who underwent revision surgery to correct lateral mislocation of the rectum following initial anorectal malformation repair. A novel surgical technique repositioning the neo-anus through the midline muscle complex achieved continence in 9 of 10 patients, with 4 regaining voluntary bowel control.
Written by the GCMD Library team from the article.
Abstract
Background
Children undergoing repair of an anorectal malformation (ARM) may have persistent soiling and/or constipation postoperatively. An anatomic reason should be sought; one of the causes for these problems that may require reoperation is mislocation of the rectum and anus outside of the muscle complex.
Methods
We reviewed our population of children who underwent re-do anorectoplasty surgery between 2014 and 2019. Indications for surgery and outcomes were recorded.
Results
Twelve patients had a lateral mislocation and underwent reoperation. There were no immediate complications in this subgroup. 9 of 10 patients are clean, and 4 are now able to have voluntary bowel movements.
Conclusion
For patients who are found to have a significant lateral mislocation, we describe a new surgical technique that replaces the rectum and neo-anus directly in the midline through the muscle complex which may improve functional outcome.