Laparoscopic rectal pull-through for persistent cloaca: an easier approach for a complex anomaly

The aim of this study was to describe the surgical technique and initial outcomes of laparoscopic-assisted anorectal pull-through for persistent cloaca.

From January 2008 to June 2010, laparoscopic-assisted rectal pull-through was performed for 10 patients with persistent cloaca. The patient ages ranged from 3 to 9 months. The operation was carried out using 4 trocars. CO(2) pressure was maintained between 8 and 12 mm Hg.

Laparoscopic-assisted rectal pull-through was successfully performed in all patients. Operative time ranged from 80 to 120 minutes (mean, 91.5 ± 10 minutes). There were no intraoperative or postoperative deaths or complications. The mean hospital stay was 4.4 ± 0.5 days (range, 4-5 days). The length of follow-up varied from 6 to 24 months (mean, 12.9 ± 5.7 months) in all 10 patients. Anal stenosis was not observed in any patient. Seven patients had 1 to 2 stools per day, 2 patients had 3 stools per day, and 1 patient had 1 stool every 2 days. No patient had fecal incontinence.

Laparoscopic rectal pull-through is a feasible, effective, and less traumatic approach for anorectoplasty in patients with persistent cloaca.