Comparison of clinical outcomes and anorectal manometry in patients with congenital anorectal malformations treated with posterior sagittal anorectoplasty and laparoscopically assisted anorectal pull through.
OBJECTIVE
The objective of this study is to analyze the clinical outcomes and anorectal manometry (AM) in infants with congenital high anorectal malformations treated with posterior sagittal anorectoplasty (PSARP) and laparoscopically assisted anorectal pull through (LAARP).


METHODS
From August 2005 to December 2008, 23 patients with congenital high anorectal malformations were randomly distributed into PSARP and LAARP groups. All of them underwent LAARP (11 cases) or PSARP (12 cases) at 2 or 3 months old. Clinical outcomes and results of anorectal manometry were compared between patients at the age of 17.4 +/- 4.9 and 19.3 +/- 6.2 months (P = .4270), respectively.


RESULTS
Kelly's clinical score for patients in LAARP and PSARP groups was 3.91 +/- 1.14 and 3.83 +/- 1.40 (P = .8827), respectively. Anal canal resting pressure and high-pressure zone length were 29.4 +/- 7.2 vs 23.4 +/- 6.5 mm Hg (P = .0479) and 14.9 +/- 3.0 vs 13.9 +/- 3.1 mm (P = .4414), respectively. Rectal anal inhibitory reflex was observed in 81.8% (9/11) and 83.3% (10/12) patients (P = 1.0000), respectively. The mean length of stay during the second hospitalization was 10.6 +/- 0.9 and 14.3 +/- 1.4 days (P < .0001), respectively.


CONCLUSIONS
Although no significant difference can be noted in clinical scoring between both groups, the results of anorectal manometry indicate that LAARP can significantly improve anal canal resting pressure and reduce the length of stay.
Yang
Jixin
J
Department of Pediatric Surgery, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Zhang
Wen
W
Feng
Jiexiong
J
Guo
Xiane
X
Wang
Guo
G
Weng
Yizhen
Y
Sun
Xiaoyi
X
Yu
Donghai
D
D001003:Anal Canal / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery*; D012809:Colon, Sigmoid / Q000601:surgery; D003125:Colostomy; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008365:Manometry / Q000379:methods / Q000706:statistics & numerical data*; D008991:Monitoring, Physiologic; D011312:Pressure; D012003:Rectal Fistula / Q000601:surgery; D012007:Rectum / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery*; D012018:Reflex / Q000502:physiology; D016896:Treatment Outcome