"Redo posterior sagittal anorectoplasty for lateral mislocation in pati" by Hira Ahmad, Devin R. Halleran et al.
 

Redo posterior sagittal anorectoplasty for lateral mislocation in patients with anorectal malformations

Document Type

Journal Article

Publication Date

1-1-2020

Journal

Journal of Pediatric Surgery

DOI

10.1016/j.jpedsurg.2020.05.029

Keywords

Anorectal malformation (ARM) reoperation; Congenital anomalies; Constipation; Continence; VACTERL

Abstract

© 2020 Elsevier Inc. Background: Children undergoing repair of an anorectal malformation (ARM) may have persistent soiling and/or constipation postoperatively. An anatomic reason should be sought; one of the causes for these problems that may require reoperation is mislocation of the rectum and anus outside of the muscle complex. Methods: We reviewed our population of children who underwent re-do anorectoplasty surgery between 2014 and 2019. Indications for surgery and outcomes were recorded. Results: Twelve patients had a lateral mislocation and underwent reoperation. There were no immediate complications in this subgroup. 9 of 10 patients are clean, and 4 are now able to have voluntary bowel movements. Conclusion: For patients who are found to have a significant lateral mislocation, we describe a new surgical technique that replaces the rectum and neo-anus directly in the midline through the muscle complex which may improve functional outcome.

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