Single-incision laparoscopic-assisted anorectoplasty for treating children with intermediate-type anorectal malformations and rectobulbar fistula: a comparative study

Ren, Xiaobin; Xu, Hang; Jiang, Qi; Diao, Mei; Li, Xu; Li, Long

doi:10.1007/s00383-019-04549-3

Cited by 13 publications

(20 citation statements)

References 29 publications

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“…We calculated pooled proportions separately for all cases operated by laparoscopy and all cases operated by laparotomy as described in Table 1. For infants treated with by laparoscopy the pooled proportion was 0.01 (95% CI 0.01-0.03; n = 7/536; I 2 = 0%; p = 0.00) 18,22,25,26,37,39,40,42,50,51,59,62 . For infants treated by laparotomy the pooled proportion was 0.02 (95% CI 0.01-0.04; n = 26/1098; I 2 = 39%; p = 0.76) 15,17,21,22,28,29,32,33,37,43,45,46,49,52,53,[55][56][57]59,63 .…”

Section: Resultsmentioning

confidence: 98%

Incisional hernia after surgical correction of abdominal congenital anomalies in infants: a systematic review with meta-analysis

Schattenkerk

Musters

Nijssen

et al. 2020

Sci Rep

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Incisional hernia (IH) in children could result in life-threatening complications, including incarceration and bowel strangulation. The incidence and risk factors of IH in infants are scarcely reported. Since IH-correction may require extensive surgery and a long recovery program, identifying infants and birth defects at risk, may lead to a different approach during the primary surgery. Therefore, the aim of this review is to systematically review the available data on the incidence of IH following surgery for congenital anomalies in infants. All studies describing IH were considered eligible. PubMed and Embase were searched and risk of bias was assessed. Primary outcome was the incidence of IH, secondary outcomes were difference in IH occurrence between disease severity (complex vs simple) and closure method (SILO vs primary closure) in gastroschisis patients. A meta-analysis was performed to pool the reported incidences in total and per congenital anomaly separately. Subgroup analysis within gastroschisis articles was performed. The 50 included studies represent 3140 patients. The pooled proportion of IH was 0.03 (95% CI 0.02–0.05; I2 = 79%, p ≤ 0.01) all anomalies combined. Gastroschisis (GS) reported highest pooled proportion 0.10 (95% CI 0.06–0.17; n = 142/1273; I2 = 86%; p ≤ 0.01). SILO closure (OR 3.09) and simple gastroschisis, i.e. without additional anomalies, (OR 0.18) were of significant influence. This review reports the incidence of IH in infants with different congenital abdominal anomalies, of which gastroschisis reported the highest risk. In GS patients, complex GS and SILO closure are risk factors for IH development.

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Section: Resultsmentioning

confidence: 98%

Incisional hernia after surgical correction of abdominal congenital anomalies in infants: a systematic review with meta-analysis

Schattenkerk

Musters

Nijssen

et al. 2020

Sci Rep

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“…Proponents of the LAARP over PSARP believe that PSARP may place the rectum within the muscle complex, but the extensive dissection and division of the muscle complex during the procedure may irreparably damage the muscle and tiny pelvic nerves leading to suboptimal functional outcome by affecting the sensation and motility component of fecal continence. LAARP may complete the procedure by minimal perineal muscle division and without damaging the nerves leading to better functional outcome [5,9,12,30,39,40].…”

Section: Discussionmentioning

confidence: 99%

“…Six of the included articles [5,9,12,15,20,30,39,40] stressed that PSARP inflicts injury to the puborectalis muscle and nerves, affecting the bowel control. However, the only experimental study conducted so far to assess the effects of the posterior sagittal approach on rectal function demonstrated that the posterior sagittal approach with or without rectotomy had minimal or no effect on bowel control.…”

Section: Discussionmentioning

confidence: 99%

Postoperative “complications" following laparoscopic-assisted anorectoplasty: A systematic review

Pathak

Saxena

2020

Pediatr Surg Int

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Aim This study reviewed the literature on the postoperative complications following laparoscopic-assisted anorectoplasty (LAARP). Methods A Medline and Embase search was performed for the terms "anorectal malformation" (ARM) "laparoscopic" and "complication". Articles without English full text, review articles, systematic reviews, case reports, case series < 5 cases and duplicate articles were excluded. Two reviewers independently performed the eligibility assessment and data extraction. Data were collected for type of malformation, surgical technique, postoperative complications and functional outcomes Results The search retrieved 108 articles, of which 38 met the inclusion criteria and offered 1058 patients for analysis. Rectoprostatic and rectobladder neck fistula were the most common types of ARM in males, whereas it was the common cloaca in females. Analysis of complications demonstrated rectal prolapse (n = 149; 14.08%) being the most prominent, followed by urethral diverticulum (n = 32; 3.02%), anal stenosis (n = 37; 3.49%), recurrent fistula (n = 7; 0.66%) and rectal stricture (n = 4; 0.37%). Krickenbeck classification was used for functional assessment in 638 patients, with fecal soiling grade 2 or > 2 in 79. Data on functional outcome specific to the type of malformation was available for 246 patients: fecal soiling grade 2 or > 2 in 15/94 (15.95%) with rectoprostatic fistula, 26/73 (35.61%) with rectobladder neck fistula, 6/47 (12.76%) with common cloaca, and 1/22 (4.54%) with no fistula. Conclusion Rectal prolapse, posterior urethral diverticulum and anal stenosis are the most common complications after LAARP. Inconsistent and non-uniform functional assessment and non-availability of information about the sacrum and spine make it difficult to analyze the functional outcome following LAARP.

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“…Li and Diao reported a case series of recto‐vesical, recto‐prostatic, and recto‐bulbar fistulas treated with single‐incision laparoscopic‐assisted anorectoplasty (SILAARP), 19 and compared the postoperative complications and fecal continence outcomes with those of PSARP 35 . As the authors admitted, the number of patients who underwent PSARP was small and the follow‐up period after SILAARP was short; nevertheless, they concluded that SILAARP was as safe, feasible, and effective as PSARP for patients with recto‐bulbar fistulas.…”

Section: Laarp Surgical Proceduresmentioning

confidence: 99%

Laparoscopically assisted anorectoplasty—Surgical procedures and outcomes: A literature review

Ishimaru

Kawashima

Hayashi

et al. 2020

Asian J Endoscop Surgery

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Anorectal malformation includes various types of anomalies. The goal of definitive surgery is achievement of fecal continence. Twenty years have passed since laparoscopically assisted anorectoplasty (LAARP) was reported by Georgeson. Since LAARP is gaining popularity, its long‐term outcomes should be evaluated. Presently, there is no evidence regarding the optimal method of ligating and dividing the fistula correctly and creating the pull‐through canal accurately. Rectal prolapse and remnant of the original fistula (ROOF) tend to develop more often in LAARP patients than in posterior sagittal anorectoplasty (PSARP) patients; however, robust evidence is not available. Prolapse may be prevented by suture fixation of the rectum to the presacral fascia; however, if prolapse occurs, the indication, timing, and the best method for surgical correction remain unclear. Most patients with ROOF are asymptomatic, and there is controversy regarding the indications for ROOF resection. This article aimed to detail the various modifications of the LAARP procedures reported previously and to describe the surgical outcomes, particularly focusing on rectal prolapse, ROOF, and fecal continence, by reviewing the literature. Functional outcomes after LAARP were almost similar to those noted after PSARP, and we have demonstrated that LAARP is not inferior to PSARP with respect to fecal continence. Although there is controversy regarding the application of LAARP for recto‐bulbar cases, we believe that LAARP is still evolving, and we can achieve better outcomes by improving the procedure.

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Single-incision laparoscopic-assisted anorectoplasty for treating children with intermediate-type anorectal malformations and rectobulbar fistula: a comparative study

Cited by 13 publications

References 29 publications

Incisional hernia after surgical correction of abdominal congenital anomalies in infants: a systematic review with meta-analysis

Incisional hernia after surgical correction of abdominal congenital anomalies in infants: a systematic review with meta-analysis

Postoperative “complications" following laparoscopic-assisted anorectoplasty: A systematic review

Laparoscopically assisted anorectoplasty—Surgical procedures and outcomes: A literature review

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