Objective: To explore the efficacies of treating infants with congenital anorectal malformation by drawing from rectal muscle sheath of blind bag out of previous sagittal approach (modified Mollard procedure).
Methods: Retrospective analyses of postoperative anus control and bowel movements were conducted for 172 patients with high anorectal malformation. The procedures included modified Mollard (n = 68, modified group), Pena (n = 64, Pena group) and abdominal perineal anus forming (n = 40, abdominoperineal group). The tensions of external sphincter and puborectalis were gauged by digital rectal examination and the perianal degree of fecal pollution was assessed by defecography.
Results: Among them, 28 boys and 18 girls had a good postoperative control of defecation in the modified group (P = 0.004). The ratios of postoperative external anal sphincter was strong were 73.5% (50/68) and 85.9% (55/64) respectively in the modified and Pena groups and they were higher than that of abdominal perineal group at 55.0% (22/40) (both P < 0.05). The difference in the former two groups was not statistically significant (P = 0.196). The incidence of constipation in the modified group was less than that in the Pena group (13.2% (9/68) vs 31.3% (20/64), P = 0.012).
Conclusion: Modified Mollard procedure may avoid repeated operations, offer a better control of bowel function, ease patient suffering and improve their postoperative quality-of-life.
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