title: [Rectal mucosa stripping and pull-through from rectal muscle sheath of blind pouch in the treatment of congenital high anal atresia in the newborn].
abstract: OBJECTIVE
  To explore the value of rectal mucosa stripping and pull-through from rectal muscle sheath of blind pouch in the treatment of congenital high anal atresia in the newborn.
  
  
  METHODS
  Clinical data of 232 newborns diagnosed as congenital high anal atresia undergoing operation from January 2001 to December 2010 were retrospectively analyzed. Among these patients, 168 underwent rectal mucosa stripping and pull-through from rectal muscle sheath of blind pouch through the previous of sagittal approach (intrathecal pull-through group), and 64 cases underwent the Pena procedure (Pena group). Patients were followed up for two years. Kelly score was used to estimate postoperative anorectal function. Defecography was used to examine the morphology of anorectum. Rectal pressure was measured as well.
  
  
  RESULTS
  Two years after operation, Kelly score revealed that 126 (75.0%) cases in the intrathecal pull-through group and 54 cases (84.4%) in the Pena group had good control defecation (P>0.05), while constipation rate was significantly lower in intrathecal pull-through group [8.3% (14/168) vs. 21.9% (14/64), P<0.05]. Postoperative barium defecography showed that defecation rectum maximum diameter was (2.2±0.3) cm in intrathecal pull-through group and (2.3±0.8) cm in the Pena group (P>0.05). Anorectal manometry showed rectal maximum capacity threshold value was (91.4±15.2) ml in the intrathecal pull-through group and (95.1±18.6) ml in the Pena group (P>0.05). There were no significant differences in defecography, anal bowel function and anorectal manometry between the two groups postoperatively (all P>0.05).
  
  
  CONCLUSIONS
  Rectal mucosa stripping and pull-through from rectal muscle sheath of blind pouch through the former sagittal can be completed with one-stage operation in newborn for the treatment of congenital high anal atresia, the efficacy of which is similar to the classic Pena operation. This procedure can avoid other operations, ameliorate the pains of newborns, decrease the burden of family, and has lower constipation rate, therefore it is a valid surgical option.
authors: Department of Surgery, The Children's Hospital of Xuzhou, Jiangsu Xuzhou 221006, China. zhanghongweizhww@sina.cn.
authors: Baobiao
authors: B
authors: Zhuo
authors: Hongwei
authors: H
authors: Zhang
authors: Yiyu
authors: Y
authors: Yin
authors: Tongsheng
authors: T
authors: Ma
authors: Fengli
authors: F
authors: Liu
authors: Hui
authors: H
authors: Cao
authors: Huaxin
authors: H
authors: Zou
mesh_terms: D001006:Anus, Imperforate / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009092:Mucous Membrane / Q000601:surgery; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies