Laparoscopically assisted anorectoplasty for intermediate imperforate anus: A report of 11 cases / 中国微创外科杂志

ABSTRACT

Objective To explore the feasibility of laparoscopically assisted one-stage anorectoplasty for the treatment of intermediate imperforate anus. Methods Under laparoscopic visualization, the rectum was mobilized. Then the rectourethral (or rectovaginal) fistula was repaired laparoscopically (6 cases) or through perineal approach (4 cases). Afterwards a tunnel was made through the center of pelvic floor musculature by combined use of laparoscopic and perineal approach. The rectum was pull-through the perineum and anastomosed with skin. At Last the colostomy was closed. Results Laparoscopically assisted anorectal pull-through was successfully performed in all cases. The mean duration of laparoscopic dissection was 32.8 minutes (range, 25~78 minutes). The mean blood loss was 5.3 ml (range, 2~10 ml). No blood transfusion was needed. The intraurethral catheter or cystostomy tube was removed on the 11th postoperative day. No intraoperative complication was encountered and all infants had uneventful postoperative recovery without wound infection. During a follow-up for 3~66 months (mean, 45 months), the fecal continence evaluation showed excellent in 8 cases and good in 3 cases. Conclusions Laparoscopically assisted anorectoplasty is an effective and minimally invasive technique for the treatment of intermediate imperforate anus. This technique has advantages of simple performance, accurate identification of the center of the pelvic floor musculature, and low infection rate.