Laparoscopic-assisted anorectal pull-through for anorectal malformations: a systematic review and the need for standardization of outcome reporting

Al-Hozaim, Omar; Almaary, Jamila; Alqahtani, Aayed R.; Zamakhshary, Mohammed

doi:10.1016/j.jpedsurg.2009.12.001

Cited by 48 publications

(15 citation statements)

References 24 publications

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“…3 Ever since laparoscopic-assisted anorectal pullthrough(LAARP) procedure for repair of high imperforate anus has been described, the role of laparoscopy in management of ARMs is expanding 8 .This is because of many perceived benefits of the technique, including minimal perineal dissection, excellent visualization of the rectal fistula and surrounding structures, and preservation of the distal rectum with accurate placement of the rectum within the levatorani and external anal sphincter muscle complex. 3 Taking all these facts in consideration, the present prospective study was conducted for a period of two years in the Department of Pediatric Surgery IMS, BHU. Sixteen patients with anorectal malformation of intermediate/high type ARM with no other associated morbid anomaly willing for surgery by laparoscopic technique were taken up as subjects of this study.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic assisted anorectoplasty in children: a prospective study

et al. 2016

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Section: Discussionmentioning

confidence: 99%

“…3 PSARP is current standard of surgical care for ARMs. This operation provides excellent exposure of the anatomy and the precise placement of the distal rectum within the muscle complex.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic assisted anorectoplasty in children: a prospective study

et al. 2016

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“…As with many new surgical techniques, the 'indications' for LAARP expanded quickly across the entire spectrum of ARMs, even including cloacal anomalies [11][12][13][14]. In their study, Tei et al [11] reported two cases of RVF associated with uterovaginal agenesis repaired by using LAARP with good functional outcome, and they recommended LAARP to be applied to selected female ARMs, in particular rectovaginal fistula and RVF with uterovaginal agenesis.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopically assisted anorectal pull-through for rectovestibular fistula

Alkhatrawi¹,

Elsherbini²,

Alturkistani³

2016

Annals of Pediatric Surgery

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Purpose Laparoscopically assisted anorectal pull-through (LAARP) has been described as an alternative to posterior sagittal anorectoplasty for the surgical treatment of rectourethral fistula in boys. The aim of the present study was to evaluate the feasibility, safety, efficacy, and advantages of LAARP in the repair of rectovestibular fistula (RVF) in girls. a prospective collection of data of our patients with RVF who were treated with LAARP, regarding demographics, VACTERL (vertebral, anal, cardiac, tracheoesophageal, renal, limb malformations) screening, perioperative measurements, complications, and outcome. Anorectal function of these patients was evaluated using Kelly's clinical score.Results Sixteen girls with RVF underwent LAARP at our hospital. For all these girls, umbilical colostomy had been performed at the time of their birth. The mean age at LAARP operation was 3 months (range = 2-5 months). Mean operative time was 99 min. Mean hospital stay was 3.2 days. There were no intraoperative complications. All the patients had their colostomy reversed. No patient had a stricture at the anorectal anastomosis. The mean follow-up time was 35.7 months (range = 6-60 months). The cosmetic appearance was satisfactory. Seven patients, who were older than 3 years, achieved continence and had regular bowel movements with good Kelly's clinical score of 6. For the remaining nine patients, the longest follow-up was 3 years, and therefore continence could not be evaluated.Conclusion LAARP for the repair of RVF in girls is feasible, safe, and efficient. Long-term follow-up, which would remain unavailable for several years, is necessary. Ann

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“…One study found that most general surgical residents are not learning how to perform pyloromyotomies in part because of the wide adoption of laparoscopic approach to this surgery [5]. And not only are pyloromyotomies being performed by MIS, so are several other designated pediatric cases such as surgery for intussusception [17], pull-through procedures [18,19], diaphragmatic hernia repairs [20], and repair of tracheo-esophageal fistula and esophageal atresia [21]. Therefore, while prior surgical residents may have performed the open version of a case, current trainees may not be offered the comparable MIS case due to insufficient skills.…”

Section: Discussionmentioning

confidence: 99%

The ACGME case log: General surgery resident experience in pediatric surgery

Gow

Drake

Aarabi

et al. 2013

Journal of Pediatric Surgery

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Background General surgery (GS) residents in ACGME programs log cases performed during their residency. We reviewed designated pediatric surgery (PS) cases to assess for changes in performed cases over time. Methods The ACGME case logs for graduating GS residents were reviewed from academic year (AY) 1989–1990 to 2010–2011 for designated pediatric cases. Overall and designated PS cases were analyzed. Data were combined into five blocks: Period I (AY1989–90 to AY1993–94), Period II (AY1994–95 to AY1998–99), Period III (AY1999–00 to AY2002–03), Period IV (AY2003–04 to AY2006–07), and Period V (AY2007–08 to AY2010–11). Periods IV and V were delineated by implementation of duty hour restrictions. Student t-tests compared averages among the time periods with significance at P < .05. Results Overall GS case load remained relatively stable. Of total cases, PS cases accounted for 5.4% in Period I and 3.7% in Period V. Designated pediatric cases declined for each period from an average of 47.7 in Period I to 33.8 in Period V. These changes are due to a decline in hernia repairs, which account for half of cases. All other cases contributed only minimally to the pediatric cases. The only laparoscopic cases in the database were anti-reflux procedures, which increased over time. Conclusions GS residents perform a diminishing number of designated PS cases. This decline occurred before the onset of work-hour restrictions. These changes have implications on the capabilities of the current graduating workforce. However, the case log does not reflect all cases trainees may be exposed to, so revision of this list is recommended.

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Laparoscopic-assisted anorectal pull-through for anorectal malformations: a systematic review and the need for standardization of outcome reporting

Cited by 48 publications

References 24 publications

Laparoscopic assisted anorectoplasty in children: a prospective study

Laparoscopic assisted anorectoplasty in children: a prospective study

Laparoscopically assisted anorectal pull-through for rectovestibular fistula

The ACGME case log: General surgery resident experience in pediatric surgery

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