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[Treatment results following the pull-through operation and continence-improving operations in high anal and rectum
Insights
Sphincter-replacement operations significantly improved continence in children with high anorectal malformations. Gracilis and palmaris-longus transplantations were among the effective reconstructive surgical procedures for fecal incontinence.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Reconstructive Urology
Context:
- Anorectal malformations (ARM) present significant challenges in pediatric surgical care.
- High atresia, a severe form of ARM, often leads to fecal incontinence.
- Electromanometrical findings indicated a high prevalence of incontinence in followed-up patients.
Purpose:
- To evaluate the effectiveness of sphincter-replacement operations in improving fecal continence in pediatric patients with anorectal malformations.
- To assess the outcomes of various reconstructive surgical techniques, including gracilis and palmaris-longus transplantations.
Summary:
- A follow-up study of 59 patients with anorectal malformations, including 71 children with high atresia, revealed that 57% experienced complete incontinence.
- Eighty-one sphincter-replacement operations were performed on 68 patients, utilizing gracilis (56), palmaris-longus (12), and stalked smooth muscle (4) transplantations.
- All reconstructive procedures demonstrated considerable improvement in fecal continence.
Impact:
- Sphincter-replacement surgery offers a viable solution for managing fecal incontinence in pediatric patients with high anorectal malformations.
- The study highlights the success of muscle flap transplantations in restoring sphincter function and improving quality of life.
Abstract:
Of 174 patients with anorectal malformations, among them 71 children with high atresia, 59 patients could be followed-up. 57% were entirely incontinent according to electromanometrical findings. These patients necessarily needed sphincter-replacement operations to improve the function of the sphincter-apparatus. Eighty-one sphincter-replacement operations were performed in 68 patients, among them 56 gracilis transplantations, 12 palmaris-longus transplantations, and 4 stalked smooth muscle transplantations. All sphincter replacement operations improved continence considerably.