Rectal atresia and stenosis: unique anorectal malformations

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• 作者：Miller Hamrick ; Bala Eradi ; Andrea Bischoff ; Emily Louden ; Alberto Peñ ; a ; Marc Levitt ; ^{Marc.levitt@cchmc.org}
• 关键词：Rectal atresia ; Rectal stenosis ; PSARP ; Presacral mass ; Anorectal malformation ; Imperforate anus
• 刊名：Journal of Pediatric Surgery
• 出版年：2012
• 期刊代码：190_00223468
• 类别：med
• 出版时间：June, 2012
• 卷：47
• 期：6
• 页码：1280-1284
• 文件大小：605 K

摘要

Introduction

Rectal atresia/stenosis is a rare disorder in the spectrum of anorectal malformations and is particularly associated with a presacral mass. These patients are born with a normal anal canal but have a stricture or complete atresia located a few centimeters proximal to the dentate line. We present a surgical technique for the management of these patients, as well as their unique clinical concerns and outcomes.

Methods

We reviewed the records of 14 patients with rectal atresia and 3 with rectal stenosis. We describe a novel technique that we have developed for the preservation of the anterior dentate line that was performed in the last 13 patients.

Results

Rectal atresia/stenosis was associated with a presacral mass in 5 patients (29%). Definitive repair was completed using a circular rectorectal anastomosis in the first 4 patients and an anterior dentate line sparing procedure in the last 13. All patients older than 3 years have demonstrated the ability to have voluntary bowel movements.

Conclusion

With the largest reported series of rectal atresia/stenosis, we have demonstrated a safe and effective technique for repair. Preoperative evaluation must be thorough because a significant number of these patients will have an associated presacral mass.