Sun Xiaobing,Li Jian,Dai Jinyu..Evaluation of anterior sagittal anoplasty for anorectal malformation with rectovestibular fistula.[J].Journal of Clinical Pediatric Surgery,,17():763-768.
Evaluation of anterior sagittal anoplasty for anorectal malformation with rectovestibular fistula.
Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R]
volume:
第17卷
Number:
2018 10
Page:
763-768
Column:
论著
Date of publication:
2018-10-25
- Keywords:
- Anus; Imperforate; Rectum/AB; Rectal Fistula; Surgical Procedures; Operative; Treatment Outcome
- Document code:
- A
- Abstract:
- ObjectiveTo evaluate the clinical efficacies of anterior sagittal anoplasty for anorectal malformation with rectovestibular fistula.MethodsA total of 25 patients with rectovestibular fistula aged from 3 months to 1 year were recruited.Barium enema and magnetic resonance imaging (MRI) were performed preoperation.Anterior sagittal anoplasty was performed in all of them.And megarectum was resected in 5 patients simultaneously.Anal endosonography (AES),anorectal manometry and anal function were evaluated at 6 months postoperation.The control group included 30 infants aged 3-9 months with abdominal distention.ResultsBefore operation,barium enema indicated megarectum in 9 cases and MRI hinted at tethered spinal cord in 2 cases.After operation,there were superficial dehiscence (n=2),rectal prolapse (n=6) and constipation (n=6).AES indicated minor damaged anal sphincter (n=11) and intact anal sphincter (n=14).The anal resting pressure and the length of anal high pressure zone (32.18±10.86 cmH2O,1.22±0.30 cm) decreased in patients as compared with controls (52.94±15.20 cmH2O,1.59±0.41 cm respectively).For 6 constipated cases,no difference existed in anal sphincter score,length of anal high pressure zone and anal resting pressure (1.00±1.27,1.28±0.42cm,34.2±16.39 cmH2O) as compared with 19 cases with normal anal function（0.95±1.27,1.24±0.29 cm,31.52±8.99 cmH2O).Two constipated cases regained normal defecation function after resecting dilated rectums.ConclusionPrimary anterior sagittal anoplasty has some complications for anorectal malformation with rectovestibular fistula.Megarectum is a major cause of postoperative constipation.Enlarged rectun should be resected simultaneously during anoplasy.
Last Update:
2018-10-24