Laparoscopically Assisted Anorectoplasty for Intermediate-Type Imperforate Anus: Comparison of Surgical Outcomes with the Sacroperineal Approach

J Laparoendosc Adv Surg Tech A. 2020 Mar;30(3):350-354. doi: 10.1089/lap.2018.0330. Epub 2018 Oct 2.


Aim: This study aimed to compare the surgical outcomes of patients with the intermediate-type imperforate anus who underwent laparoscopically assisted anorectoplasty (LAARP; L group) with those of patients who underwent sacroperineal anorectoplasty (S group). Materials and Methods: The medical records of patients with intermediate-type imperforate anus at a single institution between April 1983 and April 2017 were retrospectively reviewed. Fecal continence was evaluated using the clinical assessment score for fecal continence developed by the Japanese Study Group of Anorectal Anomalies (maximum score, 8). Results: Twelve cases (rectobulbar urethral fistula, 7; anal agenesis without fistula, 4; and rectovaginal fistula, 1) were included in the L group versus 14 cases (rectobulbar urethral fistula, 11, and anal agenesis without fistula, 3) in the S group. Age and body weight at the time of surgery and rate of associated anomalies did not differ significantly between the two groups. The total scores for fecal continence 3, 5, and 7 years after anorectoplasty were 4, 5, and 4 points in the L group and 4, 5, and 6 points in the S group, respectively, showing no significant intergroup differences. Mucosal prolapse occurred in 50% of the L group and 29% of the S group (P = .42), but failed rectocutaneous anastomosis and anal stenosis were not identified in either group. Conclusions: Postoperative fecal continence and the incidence of complications after LAARP were comparable with those after sacroperineal anorectoplasty in patients with intermediate-type imperforate anus.

Keywords: complication; fecal continence; imperforate anus; laparoscopic surgery; sacroperineal approach.

MeSH terms

  • Anal Canal / surgery
  • Anastomosis, Surgical
  • Anorectal Malformations / surgery*
  • Anus, Imperforate / surgery*
  • Body Weight
  • Fecal Incontinence / epidemiology
  • Female
  • Humans
  • Infant
  • Laparoscopy / methods*
  • Male
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications / epidemiology
  • Rectovaginal Fistula / surgery*
  • Retrospective Studies
  • Urethral Diseases / surgery*
  • Urinary Fistula / surgery*