title: Midterm follow-up study of high-type imperforate anus after laparoscopically assisted anorectoplasty.
abstract: OBJECTIVE
  The aim of this study was to evaluate postoperative anal function of high-type imperforate anus after laparoscopically assisted anorectoplasty (LAARP).
  
  
  METHODS
  Between 2000 and 2002, LAARP was performed in 13 patients with high-type imperforate anus. Clinical data of the LAARP group were compared with the posterior sagittal anorectoplasty (PSARP) group (n = 7) operated before 2000. All patients were treated with initial colostomy in the newborn period. After anorectoplasty, daily glycerin enemas were given for postoperative bowel management. Anorectal function of these patients was evaluated using the Kelly score and manometry at the age of 3 to 5 years (LAARP) and 5 to 6 years (PSARP).
  
  
  RESULTS
  Age at evaluation in the LAARP group was younger than that in the PSARP group (51 +/- 10 vs 73 +/- 12 months, P < .01). Kelly score was 3.8 +/- 1.3 vs 3.4 +/- 0.8, respectively. Resting pressure of internal sphincter was 31 +/- 11 vs 33 +/- 10 cm H(2)O, respectively. Relaxation reflex of the internal anal sphincter was observed in 62% (8/13) and 29% (2/7), respectively.
  
  
  CONCLUSIONS
  Midterm follow-up study revealed that satisfactory fecal continence can be achieved in patients with high-type imperforate anus after LAARP. Laparoscopically assisted anorectoplasty may be a good alternative in this patient population. However, long-term follow-up is necessary to compare the benefits of LAARP against PSARP.
authors.affiliation: Department of Pediatric Surgery, Saitama Children's Medical Center, Iwatsuki, Saitama 339-8551, Japan.
authors.forename: Sumi
authors.initials: S
authors.lastname: Kudou
authors.forename: Tadashi
authors.initials: T
authors.lastname: Iwanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawashima
authors.forename: Hiroo
authors.initials: H
authors.lastname: Uchida
authors.forename: Akira
authors.initials: A
authors.lastname: Nishi
authors.forename: Katsumi
authors.initials: K
authors.lastname: Yotsumoto
authors.forename: Michio
authors.initials: M
authors.lastname: Kaneko
mesh_terms: D001003:Anal Canal / Q000502:physiology / Q000601:surgery*; D001006:Anus, Imperforate / Q000601:surgery*; D005242:Fecal Incontinence; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D008365:Manometry; D012007:Rectum / Q000601:surgery*; D016896:Treatment Outcome