Primary laparoscopically assisted anorectal pull-through for high imperforate anus: A report of 4 cases
- VernacularTitle:腹腔镜高位肛门闭锁一期成形术4例报告
- Author:
Long LI
;
Qizhi YU
;
Liuming HUANG
- Publication Type:Journal Article
- Keywords:
Imperforate anus;
Laparoscopy
- From:
Chinese Journal of Minimally Invasive Surgery
2001;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility of laparoscopically assisted anorectal pull-through in the repair of high imperforate anus. Methods Four infants (3 boys and 1 girl, age range, 1 d~90 d) with high imperforate anus entered this study. During operations, the rectum was exposed via laparoscope down to the rectourethral fistula, which was ligated and dissected out laparoscopically; and then, by way of a passage through the center of pelvic floor musculature, the rectum was exteriorized to the perineum to perform anorectal anastomosis. Results Laparoscopically assisted anorectal pull-through was successfully performed in all the 4 cases as a primary procedure. The mean duration of the laparoscopy was 71 8 min (range, 45 min~90 min) and the mean blood loss 8 3 ml (range, 5 ml~20 ml), no blood transfusion required and no intraoperative complications occurred. All patients recovered uneventfully. In 3~12 months of follow-up, 1 patient was found anal stenosis at 1 month after the operation and was cured with secondary anorectoplasty. No postoperative complications were seen in the other 3 cases. By now, all the 4 patients have normal fecal continence. Conclusions Laparoscopically assisted anorectal pull-through is an effective technique in the repair of high imperforate anus. Experience has shown that this approach offers minimally invasive wounds, excellent visualization of the rectal fistula and accurate identification of the center of pelvic floor musculature.