Redo Surgeries in Anorectal Malformations: A Single-center Experience

Area of Science:

• Pediatric Surgery
• Colorectal Surgery
• Congenital Anomalies

Background:

• Anorectal malformations (ARM) are complex congenital anomalies requiring surgical correction.
• Posterior sagittal anorectoplasty (PSARP) is a common surgical approach for ARM.
• Complications following primary PSARP necessitate further surgical intervention.

Purpose of the Study:

• To present the experience of managing major redo surgeries for PSARP complications in pediatric patients.
• To highlight the diverse range of complications encountered after primary PSARP.
• To evaluate the efficacy of the posterior sagittal approach (PSA) in correcting these complex cases.

Main Methods:

• Retrospective review of patients undergoing major redo surgery for ARM complications between June 2013 and June 2019.
• Data collection from hospital records.
• Analysis of patient demographics, primary surgical history, presenting complications, and outcomes after redo surgery.

Main Results:

• Five patients (4 male, 1 female; age 5 months to 14 years) underwent redo PSARP for various complications.
• Complications included retained distal bowel, proximal urethral/bladder neck involvement, retained common channel, mispositioned neo-anus, and recto-urethral fistula.
• All patients showed symptom improvement after redo surgery; two required long-term bowel management.

Conclusions:

• Complex complications following primary PSARP for ARM can occur and require significant surgical expertise.
• The posterior sagittal approach (PSA) is a versatile and effective technique for correcting these challenging redo cases.
• Successful management may involve comprehensive bowel management strategies.