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Two-Staged Versus Three-Staged Laparoscopic Anorectoplasty for Patients with Rectoprostatic and Bladder Neck
Shuai Li1, Yuan Liu1, Xiaopan Chang1
1Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|September 6, 2019
Summary
Two-staged laparoscopic anorectoplasty (LARP) is a safe and effective treatment for rectoprostatic and bladder neck fistulas in children. This approach offers comparable outcomes to three-staged LARP but is more cost-effective and reduces hospital stay.
Area of Science:
- Pediatric Surgery
- Urology
- Gastroenterology
Background:
- Congenital rectoprostatic and bladder neck fistulas require surgical correction.
- Laparoscopic anorectoplasty (LARP) is an established surgical technique.
- The optimal number of stages for LARP in complex cases remains debated.
Purpose of the Study:
- To compare the outcomes of two-staged versus three-staged laparoscopic anorectoplasty (LARP).
- To evaluate complications, operative time, hospital stay, cost, and functional results.
- To assess the feasibility and safety of two-staged LARP for specific fistula types.
Main Methods:
- Retrospective analysis of 32 patients undergoing two-staged LARP (2010-2012).
- Comparison with 19 patients who underwent three-staged LARP (2008-2010).
- Evaluation of operative details, complications, costs, and functional outcomes using Krickenbeck scoring.
Main Results:
- Two-staged LARP demonstrated significantly shorter operative times and hospital stays.
- Total hospitalization costs were significantly lower in the two-staged group.
- No significant differences in complication rates (wound infection, recurrent fistula, rectal prolapse) or functional outcomes were observed between the two groups.
Conclusions:
- Two-staged LARP is a feasible and safe surgical option for children with rectoprostatic and bladder neck fistulas.
- The two-staged approach offers comparable functional outcomes and complication rates to the three-staged procedure.
- Two-staged LARP presents a more cost-effective alternative with reduced hospital stay.
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