Optimization of surgical treatment of congenital anal and rectal stenosis in children
DOI:
https://doi.org/10.15574/PS.2024.83.70Keywords:
congenital anorectal malformation, congenital anal stenosis, congenital rectal stenosis, associated defects, surgical tactics, transanal-posterior sagittal approach, childrenAbstract
Congenital anal (CAS) and rectal stenosis (CRS) are variants of anorectal malformations (ARM) in children.
Aim - to evaluate the results of surgical correction of CAS and CRS, based on this, to develop the main tactical requirements for the treatment of this complex pathology in children.
Materials and methods. The study included 18 children with congenital anorectal stenosis: 7 (38.9%) - with CAS, 11 (61.1%) - with CRS, which accounted for 11.7% of all treated anorectal anomalies (n=154). The ratio of boys to girls was 5:1. After complex diagnostics, in 44.4% (n=8) of children were found to have associated malformations: 42.9% (n=3) of patients with CAS and 45.5% (n=5) - with CRS.
Results. All (n=7) patients with CAS underwent one-stage surgical correction, without complications. In 90.9% (n=10) of children with CRS staged surgical treatment was performed, and one-stage in 9.1% (n=1). At the stages of primary correction of CRS postoperative complications occurred in 18.2% (n=2): stoma stenosis (n=1); urethro-perineal fistula (n=1), which were surgically corrected. After the primary correction of CRS was completed, persistent constipation was noted in 2 (18.2%) children. Repeated staged reconstructive operations were performed on these patients.
Conclusions. The use of the diagnostic, treatment and rehabilitation algorithm for CRS, developed in the clinic, made it possible to obtain good results in the long postoperative period in 63.6% (n=7) of children, and satisfactory results in 36.4% (n=4). The improved technique of surgical treatment of CAS made it possible to carry out primary correction of the defect with a good functional result in 71.4% (n=5) and satisfactory results in 28.6% (n=2) of children.
The research was conducted in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the patients was obtained for the research.
The authors declare no conflict of interest.
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