Title

Rectal atresia and stenosis: Unique anorectal malformations

Document Type

Conference Proceeding

Publication Date

6-1-2012

Journal

Journal of Pediatric Surgery

Volume

47

Issue

6

DOI

10.1016/j.jpedsurg.2012.03.036

Keywords

Anorectal malformation; Imperforate anus; Presacral mass; PSARP; Rectal atresia; Rectal stenosis

Abstract

Introduction: Rectal atresia/stenosis is a rare disorder in the spectrum of anorectal malformations and is particularly associated with a presacral mass. These patients are born with a normal anal canal but have a stricture or complete atresia located a few centimeters proximal to the dentate line. We present a surgical technique for the management of these patients, as well as their unique clinical concerns and outcomes. Methods: We reviewed the records of 14 patients with rectal atresia and 3 with rectal stenosis. We describe a novel technique that we have developed for the preservation of the anterior dentate line that was performed in the last 13 patients. Results: Rectal atresia/stenosis was associated with a presacral mass in 5 patients (29%). Definitive repair was completed using a circular rectorectal anastomosis in the first 4 patients and an anterior dentate line sparing procedure in the last 13. All patients older than 3 years have demonstrated the ability to have voluntary bowel movements. Conclusion: With the largest reported series of rectal atresia/stenosis, we have demonstrated a safe and effective technique for repair. Preoperative evaluation must be thorough because a significant number of these patients will have an associated presacral mass. © 2012 Elsevier Inc. All rights reserved.

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