Pan Deng,Liu Huifeng,Chen Li,et al.Combining case and literature reviews for preventing posterior urethral diverticulum after laparoscopic-assisted anorectoplasty[J].Journal of Clinical Pediatric Surgery,,21():1035-1039.[doi:10.3760/cma.j.cn101785-202204003-007]
Combining case and literature reviews for preventing posterior urethral diverticulum after laparoscopic-assisted anorectoplasty
- Keywords:
- Laparoscopes; Anorectal Malformations; Minimally Invasive Surgical Procedures; Diverticulum; Urethral Diseases
- Abstract:
- Objective To explore the preventive measures of posterior urethral diverticulum (PUD) after laparoscopic assisted anorectoplasty (LAARP).Methods From August 2013 to December 2018, perioperative and postoperative clinical data were reviewed for 6 children with anorectal malformation (ARM) developing PUD after LAARP.PubMed database was searched for all published English literatures of PUD after ARM surgery from 2000 to 2021.Since international naming of PUD is not standardized, there are two major names, i.e.remnant of original fistula and PUD.Thus retrieval keywords were anorectal malformation, remnant of original fistula and PUD.Results The diagnostic age was 17 months to 5 years after LAARP.The clinical manifestations included mucuria, recurrent urinary tract infection and dysuria, etc.Computed tomography (CT) and retrograde urethrography revealed prerectal cyst.A total of 13 articles were retrieved, reporting 102 cases of PUD after ARM surgery.The age was 1-44 years and the diameter of PUD 3-70 mm.The major clinical symptoms were frequent urination, dysuria, recurrent urinary tract infection, urinary calculi, hematuria and urinary incontinence, etc.Some non-symptomatic cases were only discovered accidentally during follow-ups.ARM procedures included LAARP (n=36), posterior sagittal anorectopasty (PSARP, n=15), abdominoperineal pull-through (n=15) and APP (n=50).Conclusion PUD is a rare complication after ARM surgery.And potential risks of PUD may be minimized by strengthening perioperative managements and improving surgical techniques.
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Memo
收稿日期:2022-04-01。
基金项目:河南省医学科技攻关计划联合共建项目（LHGJ20200659）
通讯作者:王献良,Email:wangxianl2009@163.com