Purpose: The aim of this study was as an introduction of a technical modification to the anterior perineal approach for the treatment of anorectal anomalies (AA) and analysis of its long-term results.
Methods: Forty-three children with AA underwent a modified anterior perineal anorectoplasty (APA), which involved the following technical guidelines: construction of a rectoanal muscular conduit through the levator ani muscle and the external anal sphincter, which were sutured to each other; preservation of the rectal end of the fistula; and invagination of the perineal skin through the neoanus. Fecal continence was assessed on average 7 years postreconstruction by Kelly's score.
Results: Of the 20 patients (19 boys) with high AA, results were good, fair and poor in, respectively, 50%, 30%, and 20% of them. Results were good and fair in, respectively, 79% and 21% of the 14 patients (all girls) with intermediate AA. All 9 patients (7 boys) with low AA had good results. The differences among groups were statistically significant (P = .016).
Conclusions: This modified APA allows for the surgeon to securely identify, preserve, and reconstruct all anatomic structures that are relevant for fecal continence. The long-term results of this initial series suggest that this modified APA is a valuable alternative for the treatment of AA.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/s0022-3468(99)90001-5 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Intrathecal Baclofen Pump Wean and Risk of Exposure in a Large TBSA Burn Wound Patient: A Case Report.
J Burn Care Res
January 2025
Indiana University, Division of Plastic Surgery, Indianapolis, IN, USA.
Burn injuries in patients with significant pre-existing medical conditions provide unique challenges in both medical management and surgical planning. Spasticity, if left untreated, can be one of the most disabling consequences of a neurologic injury. Treatment is largely dependent on pharmacologic management with anti-spasmodic agents such as baclofen.
View Article and Find Full Text PDFAnorectal malformation with rectoperineal fistula in males treated with a posterior rectal advancement anoplasty (PRAA) - report of early outcomes.
Eur J Pediatr Surg
January 2025
Surgery, Colorectal and Pelvic Reconstructive Surgery, Children's National Hospital, District of Columbia, United States.
A novel modification of the cutback procedure, a posterior rectal advancement anoplasty (PRAA) for select male patients with an anorectal malformation and a rectoperineal fistula was recently described which incised only within the limits of the sphincteric ellipse and eliminated an anterior rectal dissection, thus avoiding any possibility of a urethral injury. This report provides longer term postoperative outcomes after PRAA. Method A retrospective, single institution study was performed examining male patients with a rectoperineal fistula between 1/2020-12/2023.
View Article and Find Full Text PDFDescribing Sacrocolpopexy in Medical Literature: A Proposed Surgical Classification System.
JSLS
January 2025
Western New York Urology Associates, Cheektowaga, New York, USA. (Dr. Eddib).
Background: Sacrocolpopexy has become a favored treatment of pelvic organ prolapse due to its durability and efficacy. Sacrocolpopexy has not been standardized and there is no categorization scheme to facilitate communication or research efforts for the procedure. A systematic review was conducted to facilitate construction of a classification system for sacrocolpopexy based on extent of vaginal dissection described in the medical literature.
View Article and Find Full Text PDFThe significance of ultrasound parameters and clinical factors in predicting successful labor induction among nulliparous women.
J Matern Fetal Neonatal Med
December 2025
Department of Obstetrics and Gynaecology, Riga Stradins University, Riga, Latvia.
Objectives: To compare the values of ultrasound and clinical parameters for predicting outcomes of induction of labor (IOL) among healthy nulliparous women with a singleton, term cephalic pregnancy.
Methods: The cervical length, cervical strain elastography, posterior cervical angle, head-perineum distance, Bishop score, and maternal parameters were assessed before IOL with a combined method-Foley catheter and Misoprostol perorally. The main outcome was vaginal delivery.
Perineal deformation during forceps, vacuum and OdonAssist™ assisted vaginal deliveries: A simulation study based on advanced image processing.
Eur J Obstet Gynecol Reprod Biol
January 2025
Department of Obstetrics and Gynecology, Jean Minjoz Hospital, Besançon University Medical Center - Alexander Fleming Boulevard, 25000 Besançon, France; University of Franche-Comte-SINERGIE Laboratory, 25000 Besancon, France. Electronic address:
Objectives: The aim of this study was to analyse influence of the fetal head position and the type of instrument used (forceps, vacuum, OdonAssist™) on perineal deformation, during simulated vaginal deliveries monitored by stereophotogrammetry.
Methods: An exploratory study was conducted using mannequins simulating vaginal births. Fifty simulated deliveries were performed with different fetal head positions and instruments: Pajot's forceps, Kiwi-vacuum, and OdonAssist™.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!