Anorectal Malformation Clinical Trial
Official title:
Laparoscopically Assisted Anorectal Pull-through Versus Posterior Sagittal Anorectoplasty for High and Intermediate Anorectal Malformations : A Comparative Study
Anorectal malformations are congenital malformations, in which the terminal part of the hindgut is abnormally placed and lies outside (partially or completely) the sphincter mechanism.
The incidence of anorectal malformation ~1 in 5,000 More common in Down's syndrome and
Cat-eye syndrome. Male >female (60:40).It is classified into many types according to the
degree of descent of the rectal pouch in the pelvis, the fistula between the rectum and the
urinary system in males and genital system in females. The most common type in males is high
anorectal malformation with rectourethral fistula
There are many historical operations for the management of the high type, but the most
popular operation now is the posterior sagittal anorectoplasty which was published for the
first time in 1982. Children undergoing posterior sagittal anorectoplasty may have lifelong
bowel management problems of constipation, incontinence, and encopresis.
After the introduction of laparoscopy in pediatric surgery, many surgeons hope that the use
of laparoscopy instead of posterior sagittal anorectoplasty may reduce the complications of
the complications of the big incision and disturbance of sphincter mechanism which occur in
posterior sagittal anorectoplasty operation. In addition to its role in diagnosis in complex
anomalies like cloaca which is well established now. So the question is to what extent can
the laparoscopy replace usual surgery for anorectal malformation.
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