Earlier appearance and higher incidence of the rectoanal relaxation reflex in patients with imperforate anus repaired with laparoscopically assisted anorectoplasty

Lin, Chen-Si; Wong, Kenneth K.; Lan, Lawrence C L; Chen, Chiao-Chicy; Tam, Paul Kwong‐Hang

doi:10.1007/s00464-002-9246-3

“…For evaluation of the state of continence in this study, we mainly relied upon the number of motions per day and the presence of soiling in between motion as described by Lin et al (13) .…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the technique of LAARP the number of series in the literature is still small to draw statistical significance. However, Lin et al (13) used the number of motions per day for the early clinical assessment of nine cases of high imperforate anus after LAARP. Seven of nine LAARP patients had an acceptable frequency of one to four bowel openings per day.…”

Section: Discussionmentioning

confidence: 99%

“…Items for recording include: the day, time, amount of stool (large, average, small, or staining of clothes), and the consistency of stool either solid or liquid. Patients were classified , according to Lin et al (13) , into the following groups. Good: low number of motions per day (1-3) with large volume of stool per motion, the patient is clean between motions, with no staining.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Assisted Anorectoplasty: A New Definitive Repair of High Imperforate Anus

Gobran

¹

,

Saleh

²

,

Elekiabi

³

2014

Zagazig University Medical Journal

0

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Background/ Purpose : The classic treatment of the the high anorectal anomalies over the last 3 decade is the posterior sagittal anorectoplasty. . Laparoscopic assisted anorectoplasty is a minimally invasive technique that aims at preserving the sphincters, placing sensate skin within the control of the sphincters, and shortening recovery. The objective of this work is to evaluate the effectiveness of the laproscopic assisted anorectoplasty for the infants suffering from high imperforate anus. Materials & Methods: Twenty eight patients with high anorectal anomalies were included in this study. All patients had laparoscopically assisted anorectal pull-through (LAARP) for high imperforate anus. Hospital charts and surgical notes were reviewed and clinical characteristics tabulated. Results: Postoperative complications included rectal mucosal prolapsed (n=3), intestinal obstruction (n=1),anal stricture(n=1) ,and development of blind ended posterior urethral fistula(n=1 ). There were no complications related to the urinary system, also there was no wound infection, no hernia through the port sites, or anal retraction. Six cases developed constipation. The overall clinical assessment for continence of the cases showed that 50% had good outcome, 36% had moderate, and 14% had poor functional outcome Conclusion: LAARP for treatment of high anorectal anomalies is a feasible technique with encouraging functional results . Before recommendation of its use as a treatment of choice ,we recommend more studies for further evaluation of this technique, as the studies done for this subject are still few.

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“…In our twenty eight patients, 6 patients (21.4%) developed constipation, all these cases responded well for the conservative treatment using laxatives and bowel habit training programs. For evaluation of the state of continence in this study, we mainly relied upon the number of motions per day and the presence of soiling in between motion as described by Lin et al (13) . The overall result of our study as regard continence showed that 50% had good, 36% moderate and 14% poor results.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Assisted Anorectoplasty: A New Definitive Repair of High Imperforate Anus

Gobran

¹

,

Saleh

²

,

Elekiabi

³

2014

Zagazig University Medical Journal

0

View full text Add to dashboard Cite

Background/ Purpose : The classic treatment of the the high anorectal anomalies over the last 3 decade is the posterior sagittal anorectoplasty. . Laparoscopic assisted anorectoplasty is a minimally invasive technique that aims at preserving the sphincters, placing sensate skin within the control of the sphincters, and shortening recovery. The objective of this work is to evaluate the effectiveness of the laproscopic assisted anorectoplasty for the infants suffering from high imperforate anus. Materials & Methods: Twenty eight patients with high anorectal anomalies were included in this study. All patients had laparoscopically assisted anorectal pull-through (LAARP) for high imperforate anus. Hospital charts and surgical notes were reviewed and clinical characteristics tabulated. Results: Postoperative complications included rectal mucosal prolapsed (n=3), intestinal obstruction (n=1),anal stricture(n=1) ,and development of blind ended posterior urethral fistula(n=1 ). There were no complications related to the urinary system, also there was no wound infection, no hernia through the port sites, or anal retraction. Six cases developed constipation. The overall clinical assessment for continence of the cases showed that 50% had good outcome, 36% had moderate, and 14% had poor functional outcome Conclusion: LAARP for treatment of high anorectal anomalies is a feasible technique with encouraging functional results . Before recommendation of its use as a treatment of choice ,we recommend more studies for further evaluation of this technique, as the studies done for this subject are still few.

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“…Upon analysis of the diagnostic methods available for the assessment of the anorectal region, manometry is one among the most important tools for the identification of sphincter defects and the elucidation of fecal incontinence [12][13][14][15][16] and intestinal constipation [17][18][19]. On the other hand, sphincter trauma does not occur on a regular basis, making the grouping of patients by lesion type difficult, not to mention the fact that understanding of the lesion anatomy and physiopathology is rather poor.…”

Section: Introductionmentioning

confidence: 99%

Acute alterations in anorectal manometry induced by proximal and distal sphincterotomy. Experimental studies on piglets

Mehl

¹

,

Vicente

²

,

Dantas

³

et al. 2007

Pediatr Surg Int

3

0

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Anal incontinence causes psychological, social and adaptive troubles prejudicial to the quality of life both in children and adults. Therefore, the detailed knowledge of its causes and the improvement of diagnostic and therapeutic methods increase the possibilities of a more adequate social life to patients with congenital anomalies or sphincteric lesions or degenerations. In this work, a manometric study was developed through an experimental model so as to analyze alterations in behavior of muscle groups responsible for the anorectal sphincteric mechanism, previous to and after proximal and distal lesions. Twenty-two pigs aged between 25 and 30 days, weighing 5-7 kg, were randomly divided into two groups. They were submitted to lesions of different levels in the anorectal muscle. The animals were studied by anorectal manometry (rectoanal inhibitory reflex and vector volume) before and after the lesions. The Student t test and the Wilcoxon test were applied for the statistical analyses, considered p

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Earlier appearance and higher incidence of the rectoanal relaxation reflex in patients with imperforate anus repaired with laparoscopically assisted anorectoplasty

Abstract: In the early postoperative stage, patients repaired with LAR had more favorable findings in anorectal manometry than patients repaired with PSARP. Long-term follow-up studies to confirm a superior defecation continence achieved with LAR are warranted.

Cited by 63 publications

References 11 publications

Laparoscopic Assisted Anorectoplasty: A New Definitive Repair of High Imperforate Anus

Laparoscopic Assisted Anorectoplasty: A New Definitive Repair of High Imperforate Anus

Laparoscopic Assisted Anorectoplasty: A New Definitive Repair of High Imperforate Anus

Acute alterations in anorectal manometry induced by proximal and distal sphincterotomy. Experimental studies on piglets

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