Can Anorectal Stenosis be Managed With Dilations Alone? A PCPLC Review

Area of Science:

• Pediatric Surgery
• Colorectal Surgery
• Congenital Anomalies

Background:

• Congenital anorectal stenosis management traditionally involves dilations or operative repair.
• Recent evidence suggests dilations as a primary treatment to defer or avoid surgery.

Purpose of the Study:

• To characterize the management and outcomes of congenital anorectal stenosis.
• Utilize the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) registry for a multi-institutional review.

Main Methods:

• Retrospective database review of the PCPLC registry.
• Evaluation of patient demographics, comorbidities, diagnostic work-up, surgical interventions, bowel management, and complications.
• Analysis of 64 patients with anal or rectal stenosis across 14 centers.

Main Results:

• 13 patients (22.8% anal, 14.3% rectal) required surgical correction; PSARP was the most common procedure.
• 11 anal stenosis patients had Currarino Syndrome, with 10 having a presacral mass.
• One wound complication was noted in the anal stenosis group; bowel management showed minimal differences between treatment approaches.

Conclusions:

• The PCPLC registry indicates successful management of congenital anorectal stenosis with dilations alone is feasible.
• Posterior sagittal anorectoplasty (PSARP) remains the predominant surgical choice for operative repair.