Use of a Heineke-Mikulicz like stricturoplasty for intractable skin level anal strictures following anoplasty in children with anorectal malformations

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• 作者：Taiwo A. Lawal ; ^{takeemlawal@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Carlos A. Reck ; Richard J. Wood ; Victoria A. Lane ; Alessandra Gasior ; Marc A. Levitt
• 关键词：Anal stricture ; Anorectal malformation ; Imperforate anus ; Stricturoplasty ; Anal stenosis
• 刊名：Journal of Pediatric Surgery
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：51
• 期：10
• 页码：1743-1745
• 全文大小：573 K

文摘

We introduced a modification of the Heineke-Mikulicz technique to treat intractable skin level anal strictures post posterior sagittal anorectoplasty (PSARP). The aim of this article is to describe the technique and outcome in a series of patients.

absSec_2">Methods

This was a retrospective evaluation of patients who had Heineke-Mikulicz like stricturoplasty performed for a post PSARP skin level stricture over a one-year period.

absSec_3">Results

Five patients who were operated using the technique were reviewed. All had severe anal strictures that could admit Hegar dilator sizes 6 to 9 at 16 months to 5 years after PSARP. All underwent routine dilatations, which became increasingly painful. As an alternative to continued dilatations, an operative procedure was offered. The surgery was done as a day case and lasted 10 to 30 min. The anus at the end of the procedure could comfortably accept a Hegar dilator size 14 to 17. None of the patients had a colostomy after the procedure and there were no complications.

absSec_4">Conclusions

The Heineke-Mikulicz like stricturoplasty is a simple surgical procedure that can be done in an ambulatory setting to treat children with intractable skin level anal stricture if this develops following definitive surgery for anorectal malformations.