Unexpected megarectum: A potential hidden source of complications in patients with anorectal malformation

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• 作者：Luis De la Torre-Mondragó ; n^a ; ^c ; ^{luis.delatorre@chp.edu" class="auth_mail" title="E-mail the corresponding author} ; Claudia Bañ ; uelos-Castañ ; eda^b ; ^{claudiajbanuelosc@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Karla Santos-Jasso^b ; ^{santosjasso@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Alejandro Ruiz-Montañ ; ez^a ; ^{cirugiapediatrica@msn.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Anorectal malformation ; Imperforate anus ; Megarectum ; Rectogram ; Rectoperineal fistula ; Rectovestibular fistula
• 刊名：Journal of Pediatric Surgery
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：50
• 期：9
• 页码：1560-1562
• 全文大小：278 K

文摘

Primary posterior sagittal anorectoplasty is recommended to repair anorectal malformations with rectoperineal or rectovestibular fistula. The aim of this study was to identify the impact of the presence of megarectum on the relative frequency of complications related to posterior sagittal anorectoplasty.

Methods

We performed a cross-sectional retrospective study including patients with anorectal malformation, preoperative rectogram and surgically treated with primary or staged posterior sagittal anorectoplasty. Only complications related to anorectoplasty were analyzed and compared with the presence of megarectum.

Results

Thirty patients aged 1 day to 7 years were included, 60% had megarectum. Sixteen patients had primary repair: 6 with megarectum and 10 without megarectum; complications occurred in four of the six with megarectum, 66.7%, and no complication were observed in the 10 patients without megarectum (F p = 0.008). Fourteen patients had staged repair and no complications related to posterior sagittal anorectoplasty occurred in these patients.

Conclusions

Comprehensive preoperative evaluation in patients with anorectal malformation with rectoperineal or rectovestibular fistula could include a rectogram. Awareness of the presence of megarectum could be useful information in the decision to create a colostomy or perform a primary posterior sagittal anorectoplasty.