Primary laparoscopic repair of high imperforate anus in neonatal males

Laura R. Vick, John R. Gosche, Scott C. Boulanger, Saleem Islam

Research output: Contribution to journalArticlepeer-review

41 Citations (Scopus)

Abstract

Purpose: The standard approach to males with high imperforate anus has been a staged procedure starting with a descending colostomy, then posterior sagittal anorectoplasty with colostomy closure after 3 months. Recently, a minimally invasive approach to the repair of high imperforate anus has been described in infants after colostomy. We describe 6 newborn males with high imperforate anus successfully repaired laparoscopically as a primary, single-stage procedure. Methods: A retrospective chart review was performed on all patients with imperforate anus from October 2003 to October 2006. Results: We evaluated 9 newborn males with high imperforate anus. Of these patients, 6 underwent primary laparoscopic repair on day 1 to day 2 of life. Of these 6 patients, 3 were found to have bladder neck fistulas, whereas the other 3 had prostatic urethra fistulas. All patients passed stool within the first 72 hours postoperatively. One patient has required a procedure for a mild rectal prolapse. Follow-up ranges from 2 to 30 months in the single-stage group. Conclusion: Our early results using primary laparoscopic repair appear encouraging. Laparoscopy allows excellent visualization and assessment of the fistula and repair of high imperforate anus without need for colostomy. Long-term follow-up will be needed to assess outcomes and continence rates.

Original languageEnglish
Pages (from-to)1877-1881
Number of pages5
JournalJournal of Pediatric Surgery
Volume42
Issue number11
DOIs
Publication statusPublished - Nov 2007
Externally publishedYes

Keywords

  • High imperforate anus
  • Laparoscopic repair

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