| Surgical treatment of anorectal malformations. | |
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MedLine Citation:
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PMID: 23196862 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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The goal of surgery for anorectal malformations (ARM) is to achieve good bowel, urinary, and sexual functions, as well as the ability for children to become healthy adults. Various surgical procedures and surgical management protocols have been explored or devised by pediatric surgeons. These are described in this review. Making a correct type classification by invertography, fistelography and urethrography in the neonatal period allows pediatric surgeons to select an appropriate surgical strategy. Surgery for low-type malformations is principally neonatal perineoplasty, while that for intermediate- or high-type malformations is colostomy, followed by a pull-through operation during infancy. Posterior sagittal anorectoplasty or laparoscopy-assisted surgery has recently been accepted as alternative procedures. Fecal incontinence represents a devastating problem that often prevents a patient from becoming socially accepted and may cause serious psychological sequelae. One-third of adult patients with high- or intermediate-type malformations occasionally complain of fecal incontinence after surgery. Most patients with ARM have normal urinary function if they do not have urinary tract or sacral anomalies. These associated anomalies also influence the prognosis for sexual function, especially in males. Some female patients have experienced normal vaginal delivery and had children. In patients with cloacal malformation, however, fertility or sexual problems are also often present. Based on this information, it is clear that only well-planned and systemic treatments can provide a good functional prognosis after making a correct classification in the neonatal period. |
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Authors:
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Naomi Iwai; Shigehisa Fumino |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-11-30 |
Journal Detail:
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Title: Surgery today Volume: - ISSN: 1436-2813 ISO Abbreviation: Surg. Today Publication Date: 2012 Nov |
Date Detail:
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Created Date: 2012-11-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9204360 Medline TA: Surg Today Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Surgery, Meiji University of Integrative Medicine, Honoda, Hiyoshi-cho, Nantan-shi, Kyoto, 629-0392, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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