Title

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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