Document Detail

Treatment of anorectal anomalies by anterior perineal anorectoplasty.
MedLine Citation:
PMID:  10507419     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The aim of this study was as an introduction of a technical modification to the anterior perineal approach for the treatment of anorectal anomalies (AA) and analysis of its long-term results. METHODS: Forty-three children with AA underwent a modified anterior perineal anorectoplasty (APA), which involved the following technical guidelines: construction of a rectoanal muscular conduit through the levator ani muscle and the external anal sphincter, which were sutured to each other; preservation of the rectal end of the fistula; and invagination of the perineal skin through the neoanus. Fecal continence was assessed on average 7 years postreconstruction by Kelly's score. RESULTS: Of the 20 patients (19 boys) with high AA, results were good, fair and poor in, respectively, 50%, 30%, and 20% of them. Results were good and fair in, respectively, 79% and 21% of the 14 patients (all girls) with intermediate AA. All 9 patients (7 boys) with low AA had good results. The differences among groups were statistically significant (P = .016). CONCLUSIONS: This modified APA allows for the surgeon to securely identify, preserve, and reconstruct all anatomic structures that are relevant for fecal continence. The long-term results of this initial series suggest that this modified APA is a valuable alternative for the treatment of AA.
F D do Amaral
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  34     ISSN:  0022-3468     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-10-26     Completed Date:  1999-10-26     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1315-9     Citation Subset:  IM    
Division of Pediatric Surgery, Santa Casa de Misericórdia Central Hospital and Santa Casa School of Medical Sciences, São Paulo, Brazil.
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MeSH Terms
Anal Canal / abnormalities*,  surgery*
Child, Preschool
Digestive System Surgical Procedures / methods*
Infant, Newborn
Rectum / abnormalities*,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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