RESUMEN
Introduction: The number of patientswith various types of Anorectal malformations(AMR) are constantly increasing by ourdata. We estimate an average 10 incidenceof ARM per year and it is as twice increasedas compared to 5 patients in 1996-2000.Thepurpose of this study was to determine anincidence, types of ARM and evaluate theresults of PSARP procedure using Kelly’sscoring system.Materials and methods: A total 124patients were retrospectively reviewed andanalyzed.There were 38 patients with ARMwithout fistula, 86 patients with fistula, withprevalence of perineal fistula, 2 cloacas, 6with rectal stenosis, 7 with ectopic anus and2 with acquired atresia due to postoperativesevere anal stenosis.Results: 63 patients underwent colostomyprocedure during neonatal age, 31 patientsunderwent primary operations, 73 patientsunderwent PSARP procedure as a secondaryoperation between 4 months to 1 year ofage and 6 patients underwent redo PSARPprocedure at 8-10 years of age.One patientwith 2 cm of common channel of cloacaunderwent total urogenital mobilization at 2years of age.In 9 patients PSARP procedurewas combined with laparoscopy (LAARPprocedure with ligation of bladderneck andprostatic fistula), in 4 with laparotomy. 6patients underwent buginage of perinealfistula followed by primary PSARPprocedure.Another 6 patients underwentPSARP procedure and closure of colostomyat the same time.In 21 patients we observed6 types of complications such as severeanal stenosis acquired atresia, mislocatedanus, constipation, soiling, and recurrenceof rectouretral fistula and mortality duringneonatal age.Conclusion: The favorable results ofPSARP procedure were achieved in 71.4% ofpatients using Kelly’s clinical scoring system.Usage of Laparoscopy during abdominalstage is favorable, while it allows closureof colostomy at the same time. There is apotential for increasing of primary PSARPprocedure as though there is a prevalence oflow type malformations with perineal fistula.
RESUMEN
Introduction: Biliary Atresia is a fibroobliterativedisorder of the intra andextrahepatic bile ducts in infancy, which isgoing progressively cholestatic liver disease.The failed Kasaiportoenterostomy requiresliver transplantation. The goal of this studyis to show the outcome of Kasai operation,recent improvement and correlation the datato overseas.Methods and Materials: This study wasconducted in the department of generalsurgery of National Center for Maternal andChild Health of Mongolia between 2010 and2016 on a total of 66 infancies with biliaryatresia.Results: Patient diagnosed with biliaryatresia, which performed Kasai operationwithin first 2 months the outcome is verygood early and late post-operation period.There were 3 patients with 10 year survival, 4patients with 5-10 year and 28 patients with5 year survival after Kasai operation. The mostcomport age for liver transplantation is 1 yearlater after Kasai operation in Mongolia. Livertransplantation programme is necessary forMongolian pediatric surgery, and we thoughtour team was assembled.Conclusion: The children with biliary atresiaperform the Kasai operation within 2 monthsthe outcome is very good. Children with biliaryatresia often experience long wait times fortransplant unless exception points are grantedto reflect severity of disease.In Mongolia livertransplantation done in 2 child.