Redo posterior sagittal anorectoplasty for lateral mislocation in patients with anorectal malformations

Space: StayCurrentMD Author: Hira Ahmad, Devin R. Halleran, Elias Maloof, Jae Baek, Alessandra C. Gasior, Jacob C. Langer, Marc A. Levitt, Richard J. Wood Published:

Author / Expert

Hira Ahmad, Devin R. Halleran, Elias Maloof, Jae Baek, Alessandra C. Gasior, Jacob C. Langer, Marc A. Levitt, Richard J. Wood

Topic overview

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.

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