Related Experiment Videos
Secondary sagittal posterior anorectoplasty
1Paediatric Surgical Clinic, Children's Hospital of Cologne, Köln, Federal Republic of Germany.
Insights
This study evaluated 25 continence-improving surgeries in children. Most patients achieved improved or complete fecal continence, demonstrating the effectiveness of various surgical techniques for pediatric fecal incontinence.
Area of Science:
- Pediatric Surgery
- Colorectal Surgery
- Pediatric Urology
Background:
- Pediatric fecal incontinence presents significant challenges requiring surgical intervention.
- Various reconstructive techniques aim to improve continence in children.
Observation:
- Twenty-five continence-improving operations were performed between October 1984 and December 1986.
- Procedures included smooth muscle inversion, anterior sagittal anorectoplasty, and gracilis transposition.
- Secondary procedures were necessary for 13 patients, utilizing various sagittal approaches.
Findings:
- All 25 patients demonstrated some level of improved fecal continence post-surgery.
- Seven patients achieved complete continence, while six showed marked improvement with control of solid/pultaceous stools.
- No patient remained entirely incontinent, highlighting the success of surgical interventions.
Implications:
- Surgical management, including primary and secondary procedures, can significantly enhance fecal continence in pediatric patients.
- The use of reconstructive techniques, including utilizing existing tissue remnants, offers viable solutions for complex cases.
- These findings support the efficacy of surgical interventions in improving the quality of life for children with fecal incontinence.
Abstract:
From October 1984 to December 1986, 25 continence-improving operations were performed at the Paediatric Surgical Clinic of the Children's Hospital, Cologne. Smooth muscle inversion plasties were carried out during abdominosacroperineal pull-through procedures in eight neonates. Anterior sagittal anorectoplasties were employed in four female neonates. Secondary continence-improving procedures had to be carried out in 13 patients, with secondary sagittal anterior rectoplasties in 5 instances and posterior sagittal anorectoplasties in another 7 instances. Gracilis transposition according to Pickrell was employed in one boy. Among the seven children who underwent posterior sagittal rectoplasty, there were four patients where remnants of earlier gracilis or gluteus maximus plasties could be additionally used for creation of a continent sphincter apparatus. Among the 13 older patients with secondary continence-improving operations, 7 achieved complete continence and 6 markedly improved continence effecting continence for solid and pultaceous stools, but soiling under stress and diarrhoea. No child remained entirely incontinent.