Single-Stage Surgical Correction of Anorectal Malformation Associated with Rectourinary Fistula in Male Neonates

Leva, Ernesto; Macchini, Francesco; Arnoldi, Rossella; Cesare, Antonio Di; Gentilino, Valerio; Fumagalli, Monica; Mosca, Fabio; Bhuiyan, Akbar Husain; Torricelli, Michela; Banu, Tahmina

doi:10.47338/jns.v2.15

Cited by 11 publications

(15 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Out of 63 patients of high variety, 53 (84.12%) were males and 10 (15.87%) were females, and out of 37 patients of low type, 16 (43.24%) were males and 21 (56.75%) were females. Thus, male children have a higher chance of having a high variety of lesions than female children [5,6,7]. In the present study, we observed that children with a high type of anomaly have an increased incidence of associated anomalies.…”

Section: Discussionsupporting

confidence: 52%

“…The crux of proper management and future results mainly depends upon the exact diagnosis of the type of anomaly, identification of associated fistulous communications, and the presence of other congenital anomalies [1][2][3]. The National Institutes of Health, United States Department of Health, and Human Services stated that about one in every 5,000 neonates is born with anorectal malformations (ARMs), with an increased preponderance among males [4][5][6]. Various surgical procedures have been adopted depending on the level of the distal rectal pouch and its relation to the puborectalis sling.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Study of the Clinical Profile and Management of Children With Anorectal Malformations

Chanchlani¹,

Budhwani²

2023

Cureus

View full text Add to dashboard Cite

The diagnosis of anorectal malformations (ARMs) antenatally is rare, and most of these cases are diagnosed in the neonatal period. The defects range from easily treated minor anomalies with good prognosis to those that are difficult and complex. The associated anomalies in these malformations are important determinants for the prognosis and outcome of these cases. Material and methodsThe present study was carried out in the department of pediatric surgery in a tertiary care institute. Patients presenting with ARMs in the neonatal period, those reported for definitive surgery, and patients for colostomy closure surgery were included. Patients who died before surgical treatment were excluded from the study. Convenience sampling of 100 patients who met the inclusion criteria was performed until the sample size was reached. ResultsOut of 63 cases of high variety, 84.12% were males and 15.87% were females. Out of 37 patients of low variety, 43.24% were males and 56.75% were females. The anomalies of the urogenital system were present in 22 (34.92%) out of 63 cases of high ARMs and 10 (27.02%) out of 37 cases of low ARMs. In the male patients, anocutaneous fistula was in 16 (23.18%) of cases. Out of 31 females in the present study, anorectal agenesis with anovestibular fistula was seen in 19 (61.29%) cases. In the early complications, significant bleeding and urethral injury were seen in one (2.63%) patient each. However, among the late complications, anal stenosis, mucosal prolapse, and wound infection were seen in seven (18.42%), five (13.15%), and four (10.52%) patients, respectively. ConclusionA holistic approach to the management of ARMs is needed with a long-term goal of achieving urinary and fecal continence with good quality of life. The outcome of surgery is dependent on the specific type of malformation, but the results are better when intervention is done early.

show abstract

Section: Discussionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

A Study of the Clinical Profile and Management of Children With Anorectal Malformations

Chanchlani¹,

Budhwani²

2023

Cureus

View full text Add to dashboard Cite

show abstract

“…[2,8,9,10] These patients who do not return at 6-8 weeks for the definitive procedure have lower chances of early restoration of defecation reflex. [1,2,6,[11][12][13][14][15][16] As per Pena, primary definitive surgery can be done in male neonates depending on surgeons' experience and condition of neonates, provided the neoanus is placed well within the sphincter muscle complex. [17] Nagdeve et al reported good continence with primary PSARP.…”

Section: Discussionmentioning

confidence: 99%

Primary Posterior Sagittal Anorectoplasty in male neonates with Anorectal Malformations: A tertiary care hospital experience

Tiwari¹,

Shenoy²,

Gandhi³

et al. 2021

J Neonatal Surg

View full text Add to dashboard Cite

Background: The conventional surgical management for a male neonate with intermediate Anorectal Malformation (ARM) involves three stages – the creation of a diversion stoma in the neonatal period, a definitive pull-through procedure/ Posterior Sagittal Anorectoplasty (PSARP) followed by stoma closure. With this background, we present our experience with Single-stage primary definitive repair in selected male neonates with ARM. Methods: Medical records of male ARM cases managed from 2016 to 2018 were reviewed. Male neonates who underwent primary PSARP were analysed retrospectively. Results: A total of 35 records were found, out of which 12 male neonates underwent primary PSARP. The median gestational age and birth weight were 36.7 weeks and 2.75 kg respectively. Fistula with urinary tract was documented in all. The mean operative time was 65 minutes +/- 15 minutes. Two neonates had minor superficial surgical site infection at neo-anus. Anal dilatations were started after 2 weeks. At follow-up period of 3 years, 11 patients were continent; one patient had constipation with pseudo-incontinence which was successfully being managed by bowel management programme. Conclusions: A primary definitive procedure is feasible when performed on carefully selected male neonates with ARM and also avoids the morbidity of stoma and multiple surgeries and follow-up visits to hospitals.

show abstract

“…The cause has not been fully elucidated but it is likely to be multifactorial and include genetic and environmental factors [6,7]. Males are more affected than females and may occur as a single abnormality or a combination of abnormalities [8][9][10]. ARMs have been reported to be associated with other congenital anomalies in up to 70% of cases [8,9,11].…”

Section: Introductionmentioning

confidence: 99%

“…Males are more affected than females and may occur as a single abnormality or a combination of abnormalities [8][9][10]. ARMs have been reported to be associated with other congenital anomalies in up to 70% of cases [8,9,11]. The final prognosis and quality of life for children with ARMs depend, to a large extent, on the presence and severity of these associated anomalies [11].…”

Section: Introductionmentioning

confidence: 99%

Outcome of Divided and Loop Sigmoid Colostomy for the Management of Anorectal Malformation (ARM): A Comparative Study

Hossain¹,

Rahman²,

Saifullah³

et al. 2023

Glob Acad J Med Sci

View full text Add to dashboard Cite

Background: Anorectal Malformation (ARM) is one of the common congenital anomalies in the world. There are various surgical options for management of ARM. Colostomy is usually performed as a first stage in a new born with high and intermediate variety of anorectal malformations. The aim of the study was to compare the clinical outcomes between divided and loop sigmoid colostomy for the management of anorectal malformations. Material and Methods: This prospective comparative study was conducted on 130 pediatric patients at the Faculty of Pediatric Surgery, Bangladesh Shishu Hospital and Institute, who were admitted with anorectal malformations (ARM) up to 7 days of age, from March 2018 to February 2021. Informed consent was obtained after proper counselling with the guardian. They were randomly assigned to the divided sigmoid colostomy group (group 1=65 neonates) and loop sigmoid colostomy group (group 2=65 neonates). The comparative parameters between two groups were the operation time, post-operative complications such as wound infection, skin excoriation, prolapse of colostomy, retraction of colostomy and parastomal hernia. All patients were followed up for 2 months post-operatively. Results: The mean age of the patients was 2.43±1.39days in group 1 and in group 2, the mean age was 2.61±1.73 days where majority of the patients were male. The statistical difference between the two groups regarding operation time was highly significant (0.0001). After operation, 26.15% patients developed skin excoriation in group 1 where in group 2, 29.23% patients developed skin excoriation. In group 1, 6.15% patients developed wound infection but none of them developed prolapse, retraction of colostomy and parastomal hernia. On the other hand, in group 2, 1.54% patient developed wound infection, 15.38% patients developed prolapse and 6.15% patients developed retraction of colostomy and no patient experienced parastomal hernia. The statistical difference between the two groups regarding prolapse of colostomy was significant (p=0.042). Conclusion: In our study, the frequency of different stoma-related problems was greater in the loop colostomy group, although being statistically insignificant. In the divided group, there was significantly less stoma prolapse. In light of these results, divided stoma should be suggested for newborns with ARM.

show abstract

Single-Stage Surgical Correction of Anorectal Malformation Associated with Rectourinary Fistula in Male Neonates

Cited by 11 publications

References 4 publications

A Study of the Clinical Profile and Management of Children With Anorectal Malformations

A Study of the Clinical Profile and Management of Children With Anorectal Malformations

Primary Posterior Sagittal Anorectoplasty in male neonates with Anorectal Malformations: A tertiary care hospital experience

Outcome of Divided and Loop Sigmoid Colostomy for the Management of Anorectal Malformation (ARM): A Comparative Study

Contact Info

Product

Resources

About