Anorectal malformation with rectobladder neck fistula: A distinct and challenging malformation

Samuk, Inbal; Bischoff, Andréa; Hall, Jennifer; Levitt, Marc A.; Peña, Alberto

doi:10.1016/j.jpedsurg.2016.06.001

Cited by 19 publications

(13 citation statements)

References 11 publications

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“…The outcomes from our cross-sectional evaluation concur almost precisely with the outcomes from the large series of Levitt and Peña 38 (Table 3). The largest series to date on boys with rectobladderneck fistula of 69 patients, 48 also from Peña's group, identified a 75% requirement for ACE bowel management in these patients, consistent with our data (Table 3). This highlights the need to prepare for secondary interventions to assure acceptable continence from early on in these cases.…”

Section: Continence Prognosis By Level Of Rufsupporting

confidence: 89%

Long-term bowel function, quality of life and sexual function in patients with anorectal malformations treated during the PSARP era

Kyrklund

Pakarinen

Rintala

2017

Seminars in Pediatric Surgery

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Anorectal malformations are an important group of congenital anomalies that vary widely in their anatomical characteristics and complexity. Understanding the long-term functional outcomes after modern treatments, and how these compare to the general population, are essential for ensuring that patients receive optimal, evidence-based care. With increasing appreciation of the wider impact of the illness on patients and their families, minimizing social disability from fecal incontinence and enabling normal social integration from the outset are key management concerns. This review summarizes the current knowledge on the functional outcomes by type of malformation, reflecting on the literature, and our institutional experience over a follow-up period of nearly 30 years.

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Section: Continence Prognosis By Level Of Rufsupporting

confidence: 89%

Long-term bowel function, quality of life and sexual function in patients with anorectal malformations treated during the PSARP era

Kyrklund

Pakarinen

Rintala

2017

Seminars in Pediatric Surgery

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“…Seven articles compared PSARP with LAARP, while other articles discussed specific laparoscopic approaches or reported series. [3][4][5][6][7][8][9][10] One article discussed laparoscopic colostomy creation in the setting of LAARP. 11 Three articles reported the use of laparoscopy for the mobilization of the rectal component in cloaca repairs.…”

Section: Resultsmentioning

confidence: 99%

“…[4][5][6][7][8][9]22 The outcomes variably evaluated by the authors were: perioperative clinical results, rectal manometry, magnetic resonance imaging (MRI), length of stay, and complications. Ten articles described the radiographic features of the sacrum/spinal cord [7][8][9][10][11][23][24][25][26][27][28][29] and five reported a sacral ratio calculation. [7][8][9][10]27,28,30 Clinical results were reported in nine using various scoring systems.…”

Section: Resultsmentioning

confidence: 99%

“…Ten articles described the radiographic features of the sacrum/spinal cord [7][8][9][10][11][23][24][25][26][27][28][29] and five reported a sacral ratio calculation. [7][8][9][10]27,28,30 Clinical results were reported in nine using various scoring systems. 5,[8][9][10][12][13][14][15]22,25,28,[31][32][33] One article compared the manometric results between PSARP and LAARP.…”

Section: Resultsmentioning

confidence: 99%

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The Role of Laparoscopy in Anorectal Malformations

et al. 2020

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The use of laparoscopy in the minimally invasive management of anorectal malformations (ARMs) continues to evolve, although the principles guiding the anatomic surgical repair and clinical follow-up remain unchanged. In this review, we detail the advantages, indications, contraindications, complications, and issues unique to the minimally invasive approach to ARM. A comprehensive search of the PubMed and Embase databases was performed (2014–2018). Full-text screening, data abstraction, and quality appraisal were performed of articles describing the use of laparoscopy in ARM and cloaca. While new developments and approaches to ARM utilizing minimally invasive techniques and timing for surgical approach have been detailed, a unique complication profile involving greater risk of rectal prolapse and retention of a remnant of the original fistula are still consistently reported. Analysis of perioperative complications and long-term functional outcomes, including rates of fecal and urinary continence, are lacking. It is clear that patient selection for the choice of surgical approach based on precise preoperative delineation of the anatomy is the key. Adherence to the principles of ARM repair as well as application of operative/imaging adjuncts will yield the best technically safe minimally invasive approach to ARM. Continued efforts for standardized reporting and long-term follow-up are required.

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“…The combination of a single kidney with troublesome vesicoureteral reflux in anorectal malformation is relatively common and must be closely watched to prevent renal deterioration. [1011] A higher rectourinary fistula is linked to a greater risk of infection in two ways – first, it is invariably wider and more contaminating; second, it is associated with greater neurovesical dysfunction. The described protocol for solitary renoureteric units incorporating directed imaging and cystoscopy clarifies the pathological anatomy at the earliest and ensures optimal continued surveillance, especially in the 1 st year of life during renal growth.…”

Section: Discussionmentioning

confidence: 99%

Solitary functioning kidney in high anorectal malformation

Das

Rajkiran

2017

J Indian Assoc Pediatr Surg

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Aim:A solitary functioning renal unit in high anorectal malformation may harbor anomalies in the upper/lower urinary tract that further compromise renal function and accelerate hyperfiltration injury. We aimed to analyze the clinical course, management, and outcome of children with a solitary renal unit and high anorectal malformation.Materials and Methods:A cohort of solitary renal units in anorectal malformation managed between 2000 and 2015 with a defined protocol at a pediatric nephro-urology clinic are included in the study. Investigations and management were individualized according to issues in the agenetic/dysplastic unit, solitary functioning unit, or bladder-urethra. Clinical details, management, and outcome were analyzed.Results:Of 53 cases of high anorectal malformation with urologic anomalies, 17 (32%) had single kidneys. Majority (10/17, 59%) had another complicating urinary tract anomaly, four being uremic at presentation. Nearly half had multiple urinary infections including epididymo-orchitis unrelated to the rectourinary fistula and warranted additional stoma (bowel/urinary) or other urinary tract surgery. At a mean follow-up of 70 months, majority (14/17, 82%) have a preserved solitary renoureteric unit while the remaining three await renal replacement therapy.Conclusion:Solitary functioning renal units associated with high anorectal malformation in children need meticulous investigation and surveillance to facilitate renal preservation. The implications of the associated rectourinary fistula, vesicoureteral reflux, urinary infections including epididymo-orchitis, and other urinary tract anomalies on the conventional surgical management are illustrated.

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Anorectal malformation with rectobladder neck fistula: A distinct and challenging malformation

Cited by 19 publications

References 11 publications

Long-term bowel function, quality of life and sexual function in patients with anorectal malformations treated during the PSARP era

Long-term bowel function, quality of life and sexual function in patients with anorectal malformations treated during the PSARP era

The Role of Laparoscopy in Anorectal Malformations

Solitary functioning kidney in high anorectal malformation

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