Wang Weiao,Zheng Zebing,Liu Yuanmei,et al.Comparative analysis of the efficacy of laparoscopic-assisted anorectoplasty with posterior sagittal anorectoplasty for anal atresia and vestibular fistula[J].Journal of Clinical Pediatric Surgery,,():229-233.[doi:10.3760/cma.j.cn101785-202211057-005]
Comparative analysis of the efficacy of laparoscopic-assisted anorectoplasty with posterior sagittal anorectoplasty for anal atresia and vestibular fistula
- Keywords:
- Anorectal Malformation; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the efficacy of laparoscopic-assisted anoplasty(LAARP) and modified semi posterior sagittal anorectoplasty (modified Pe?a) in children with anal atresia and vestibular fistula (AVF).Methods From April 2012 to September 2021,43 AVF children were retrospectively reviewed.According to the specific operative techniques,they were assigned into two groups of LAARP (n=16) and modified Pe?a (n=27).Age of operation,operative duration,intraoperative volume of blood loss,length of hospital stay and postoperative complications (incision infection/dehiscence,rectum retraction,rectal mucosa eversion,anal stenosis & fistula recurrence) were collected.And postoperative defecation control function was compared between two groups by Lee’s clinical score.Results There was no significant differences existed in operative age or hospitalization stay between LAARP and modified Pe?a groups (P>0.05).Operative time was longer in LAARP group than that in modified Pe?a group(P＜0.05).Intraoperative blood loss was lower in LAARP group than that in modified Pe?a group(P＜0.05).No significant inter-group difference existed in the incidence of incision infection/dehiscence or anal stenosis (P>0.05).Three children developed complicated rectal retraction in modified Pe?a group while no rectal retraction occurred in LAARP group (P>0.05).The incidence of rectal mucosal eversion was higher in LAARP group than that in modified Pe?a group (P>0.05).No fistula recurred in neither groups.Postoperative defecation function showed no significant inter-group difference (P>0.05).Conclusions LAARP is a safe and effective operation for the treatment of AVF,which can reduce the intraoperative bleeding.The long-term defecation function is the same as modified Pe?a.However,we should highlight the probability of postoperative rectal mucosal eversion and the increased operating time.
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Memo
收稿日期:2023-7-8。
基金项目:国家自然科学基金(82060100);贵州省基础研究项目(黔科合基础ZK-2021-361)
通讯作者:刘远梅,Email:yuanmei116@aliyun.com