180 results match your criteria anorectoplasty psarp


Simultaneous Endoscopic Management of Urethral Duplication and Postposterior Sagittal Anorectoplasty Urethral Diverticulum in a Boy with Anorectal Malformation.

J Indian Assoc Pediatr Surg 2021 May-Jun;26(3):200-202. Epub 2021 May 17.

Department of Paediatric Surgery, Maulana Azad Medical College, Associated Lok Nayak Hospital, New Delhi, India.

We report a case of urethral duplication with high anorectal malformation (ARM). A 12-year-old boy who had undergone transverse colostomy on day 2 of life and posterior sagittal anorectoplasty (PSARP) for ARM (rectobulbar fistula) at 8 years and also had urinary dribbling from a midscrotal opening in addition to normal voiding, presented with recurrent urinary tract infections and dysuria. Midscrotal dribbling had continued postoperatively. Read More

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Evaluation and management of rectovaginal fistula in anorectal malformation: an observational study.

Pediatr Surg Int 2021 Jul 20. Epub 2021 Jul 20.

Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, 226003, India.

Purpose: The rectovaginal fistula (RVF) is a type of female ARM in which the rectum terminates in the vagina. Due to its rarity, there are limited reports on its presentation, management, and follow-up. This paper deals with the clinical presentation, management, and outcome of RVF. Read More

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Anorectal Malformation with Rectovestibular Fistula and Vaginal Agenesis: Usage of Rectovestibular Fistula as a Neovagina Followed by PSARP with Preservation of the Anal Sphincter.

European J Pediatr Surg Rep 2021 Jan 12;9(1):e51-e55. Epub 2021 Jul 12.

Department of Pediatric Surgery, National Children Hospital and Vinmec International Hospital, Hanoi, Vietnam.

Anorectal malformation with rectovestibular fistula associated with vaginal agenesis is rare. We report on a child in whom this combination was diagnosed at the age of 1 year. After creation of a divided descending colostomy, we chose to leave the rectum-rectovestibular fistula to function as a neovagina, while the sigmoid colon was relocated via modified posterior sagittal anorectoplasty. Read More

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January 2021

Neonatal Renal Failure in the Setting of Anorectal Malformation: A Case Report and Literature Review.

Cureus 2021 May 12;13(5):e14984. Epub 2021 May 12.

Pediatric Surgery, University of Missouri Kansas City School of Medicine, Kansas City, USA.

Anorectal malformations (ARMs) can occur in isolation or in association with other anomalies, most commonly those of the genitourinary systems. Morbidity and mortality are highest among patients who develop end-stage renal disease (ESRD) either from severe congenital anomalies (dysplastic kidneys) or from repeated infections in those who have vesicoureteral reflux or persistent recto-urinary fistulas. We describe our management strategy for a patient born with an ARM and bilateral dysplastic kidneys to highlight the nuances and complex decision-making considerations required in taking care of this complex patient population. Read More

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A case report: Common channel anomaly with vaginal agenesis and rectal stone after posterior sagittal anorectoplasty (PSARP).

Int J Surg Case Rep 2021 Jun 26;83:106032. Epub 2021 May 26.

Urogynecology Division Department of Obstetrics and Gynecology, Faculty of Medicine, University of Indonesia/ Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Electronic address:

Introduction And Importance: We reported a case of common channel anomaly complicated with vaginal agenesis and rectal stone, which is a long-term complication of PSARP, a combination of very rare conditions with high morbidity and especially difficult treatment.

Presentation Of Case: A 15-year-old female presented with a chief complaint of cyclic abdominal pain. The patient had no history of menstruation before. Read More

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Are routine postoperative dilations necessary after primary posterior sagittal anorectoplasty? A randomized controlled trial.

J Pediatr Surg 2021 Aug 30;56(8):1449-1453. Epub 2021 Apr 30.

Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, USA.

Aim Of The Study: For the past four decades, routine daily postoperative anal dilation by parents has been the standard treatment following a primary posterior sagittal anorectoplasty (PSARP). However, the clinical benefit of this practice has never been formally investigated. It is known that dilations can have a significant negative psychological impact on patients and families, and therefore, we aimed to study if routine dilations after a PSARP are necessary. Read More

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Lessons learned from lower urinary tract complications of anorectoplasty for imperforate anus with rectourethral/rectovesical fistula: Laparoscopy-assisted versus posterior sagittal approaches.

J Pediatr Surg 2021 Jul 26;56(7):1136-1140. Epub 2021 Mar 26.

Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.

Purpose: To report the sequelae of and preventive strategies for selected lower urinary tract (LUT) complications, i.e., posterior urethral diverticulum (PUD), intraoperative LUT injuries, postoperative dysuria, and fistula recurrence in male imperforate anus (IA) with rectourethral/rectovesical (RU/RV) fistula after laparoscopy-assisted anorectoplasty (LAARP) or posterior sagittal anorectoplasty (PSARP). Read More

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Commentary on can complex surgical interventions be standardized? Reaching international consensus on posterior sagittal anorectoplasty using a modified-Delphi method.

Authors:
Russell K Woo

J Pediatr Surg 2021 Aug 2;56(8):1328-1329. Epub 2021 Mar 2.

John A. Burns School of Medicine, University of Hawaii, 1319 Punahou Street, Suite 600, Honolulu, HI 96826, United States. Electronic address:

This is a commentary on the manuscript entitled "Can Complex Surgical Interventions be Standardized? Reaching International Consensus on Posterior Sagittal Anorectoplasty Using a Modified-Delphi Method" by Hanke, R, Ponsky T, Garrison A, et al. Read More

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Colostomy Takedown: Ischemic Complication following Anorectal Malformation Surgery.

Case Rep Surg 2021 12;2021:8870631. Epub 2021 Jan 12.

Comprehensive Colorectal Center, Department of Surgery, Children's Mercy Kansas City, Kansas City, MO 64108, USA.

Introduction: Anorectal malformations (ARM) are complex disorders that often require staged reconstructions. We present a case and imaging findings of a child who developed issues following colostomy closure due to segmental colonic ischemia. . Read More

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January 2021

Does a standardized operative approach in cloacal reconstruction allow for preservation of a patent urethra?

J Pediatr Surg 2021 Jan 14. Epub 2021 Jan 14.

Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA. Electronic address:

Background: Cloacal malformations are recognized as a particularly challenging congenital condition to manage and they present with a wide spectrum of anatomical configurations making surgical repair very complicated. Urethral necrosis or urethral loss is a known and devastating complication of cloacal repair. The surgical repair of these malformations has evolved over time and historically only common channel (CC) length was measured. Read More

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January 2021

Can complex surgical interventions be standardized? Reaching international consensus on posterior sagittal anorectoplasty using a modified-Delphi method.

J Pediatr Surg 2021 Aug 8;56(8):1322-1327. Epub 2021 Jan 8.

Indiana University School of Medicine, Department of Emergency Medicine, Indianapolis, USA. Electronic address:

Background/purpose: In an effort to standardize educational experience, address future physician shortages, and improve quality of care to patients, many surgical specialties are discussing how to maximize exposure to index cases. One solution being explored is telementoring, which requires a well-developed educational curriculum with intraoperative objectives. The American College of Surgery Telementoring Task Force selected anorectal malformation and posterior sagittal anorectoplasty (PSARP) for the repair of imperforate anus as the initial educational focus for this pilot. Read More

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An overview of opioid usage and regional anesthesia for patients undergoing repair of anorectal malformation.

Pediatr Surg Int 2021 Apr 7;37(4):457-460. Epub 2021 Jan 7.

International Center for Colorectal and Urogenital Care, Department of Pediatric Surgery, Children's Hospital Colorado, 13123 East 16th Avenue, Anschutz Medical Campus, Box 323, Aurora, CO, 80045, USA.

Purpose: The recent opioid crisis in the USA compelled us to evaluate our practice of opioid use for postoperative pain management and the influence of regional anesthesia on opioid requirement in patients undergoing repair of anorectal malformations.

Methods: A retrospective chart review was performed evaluating patients who underwent posterior sagittal anorectoplasty (PSARP) and posterior sagittal anorecto-vagino-urethroplasty (PSARVUP), with or without laparotomy, between January 2016 and March 2020. Morphine milligram equivalents per kilogram (MME/kg) were calculated. Read More

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Challenges, constraints and failures that are related to the posterior sagittal anorectoplasty approach to anorectal malformations in a low-resource context: An experience from a sudanese tertiary referral centre.

Afr J Paediatr Surg 2020 Jul-Dec;17(3 & 4):79-84

Department of Mother and Child Health, Pediatric Surgery Unit - San Camillo Forlanini Hospital, Rome, Italy.

Background: Anorectal malformations (ARMs) in the sub-Saharan Africa are a common cause of neonatal referral for intestinal obstruction, and the posterior sagittal anorectoplasty (PSARP) approach is rapidly spreading. The small number of paediatric surgeons and the low-resource context limit children's access to care and constrain the quality of results. A retrospective, observational study has been done on a consecutive series of ARM cases admitted to a Sudanese tertiary paediatric surgical centre within the framework of a partnership between Italian and Sudanese academic institutions addressed to review and upgrade the standard of care of major congenital anomalies. Read More

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Lasting impact on children with an anorectal malformations with proper surgical preparation, respect for anatomic principles, and precise surgical management.

Semin Pediatr Surg 2020 Dec 8;29(6):150986. Epub 2020 Nov 8.

Department of Surgery, Boston Children's Hospital, Boston, MA, USA.

Optimal outcomes in the management of children with Anorectal Malformation (ARM) require careful surgical preparation and detailed understanding of the anatomic principles and operative setup. A clear understanding of operative anatomy and surgical principals guides decision making. Adherence to the principles of ARM repair, as well as the application of operative and imaging adjuncts, will yield the safest and most successful approach to ARM. Read More

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December 2020

Four-hour voiding observations detect neurogenic lower urinary tract dysfunction in neonates with anorectal malformation.

J Pediatr Urol 2021 02 16;17(1):76.e1-76.e9. Epub 2020 Oct 16.

Department of Paediatric Surgery, Queen Silvia Children's Hospital, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; The Paediatric UroNephrologic Centre, Queen Silvia Children's Hospital, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.

Introduction: Neurogenic lower urinary tract dysfunction (LUTD) has been reported in 20-50% of children with anorectal malformations (ARM). As neurogenic LUTD represents an inherent risk of renal deterioration and urinary tract infections, an early diagnosis is important. The gold standard for evaluating neurogenic LUTD involves invasive urodynamic testing but a useful addition should be an easy-to-perform, non-invasive method of screening. Read More

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February 2021

Magnetic resonance imaging of the anal sphincter and spine in patients with anorectal malformations after posterior sagittal anorectoplasty: a late follow-up cross-sectional study.

Pediatr Surg Int 2021 Jan 3;37(1):85-91. Epub 2020 Nov 3.

Department of Surgery, Odense University Hospital, 5000, Odense C, Denmark.

Purpose: We aimed to assess the association of fecal incontinence to the anatomy of the anal sphincter complex and lower bony spinal anomalies as investigated with magnetic resonance imaging (MRI) in adolescents and adults with anorectal malformations (ARM) after posterior sagittal anorectoplasty (PSARP).

Methods: We conducted a cross-sectional study in 20 patients with ARM after PSARP. Anatomy of the anorectum and spine were examined with MRI and functional outcome assessed with the Wexner incontinence score. Read More

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January 2021

Anorectal anomalies in the female: Highlights on surgical management.

J Pediatr Surg 2021 Sep 16;56(9):1570-1575. Epub 2020 Sep 16.

Department of General Surgery, Faculty of Medicine, Benha University, Benha, Egypt; Medical Science Department, Sulaiman Al-Rajhi University, Al Bukayriah, Saudi Arabia.

Background: Anorectal anomalies (ARA) are characterized by different clinical presentations in both sexes with consequently different management protocols. There exist several controversies and different strategies to manage ARA in the female.

Purpose: To present our experience in managing girls with ARA highlighting the rationale behind the chosen protocol. Read More

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September 2021

Laparoscopically assisted anorectoplasty-Surgical procedures and outcomes: A literature review.

Asian J Endosc Surg 2021 Jul 8;14(3):335-345. Epub 2020 Oct 8.

Division of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan.

Anorectal malformation includes various types of anomalies. The goal of definitive surgery is achievement of fecal continence. Twenty years have passed since laparoscopically assisted anorectoplasty (LAARP) was reported by Georgeson. Read More

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Transfistula anorectoplasty on adult female anorectal malformation: A rare case report.

Int J Surg Case Rep 2020 19;74:182-185. Epub 2020 Aug 19.

Urogynecology Division Department of Obstetrics and Gynecology, Faculty of Medicine University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Electronic address:

Introduction: Female anorectal malformation (ARM) is correctable congenital defects. Delayed presentation of patients with anorectal malformation is uncommon. However, presentation beyond teenage years is not commonplace. Read More

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Vacuum-assisted closure (VAC) prevents wound dehiscence following posterior sagittal anorectoplasty (PSARP): An exploratory case-control study.

J Pediatr Surg 2021 Apr 12;56(4):745-749. Epub 2020 Jul 12.

Department of Pediatric Surgery, University of Leipzig, Leipzig, Germany.

Background: Wound dehiscence (WD) of the anocutaneous anastomosis or perineal body after posterior sagittal anorectoplasty (PSARP) is common. We aimed to evaluate the efficacy of a perineal vacuum-assisted closure (VAC) for prevention of WD following repair of anorectal malformations (ARM) with rectoperineal and rectovestibular fistula.

Methods: A retrospective dual-center case-control study of children undergoing PSARP without colostomy between 2011 and 2019 was performed. Read More

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Are Self-Assessment and Peer Assessment of Added Value in Training Complex Pediatric Surgical Skills?

Eur J Pediatr Surg 2021 Feb 9;31(1):25-33. Epub 2020 Aug 9.

Department of Pediatric Surgery, Radboudumc, Nijmegen, The Netherlands.

Introduction:  Self-assessment aids "reflection-before-practice," which is expected to result in a better understanding of one's strengths and weaknesses and consequently a better overall performance. This is, however, rarely used in surgical training. This study aims to evaluate the correlation between self-, peer-, and expert assessment on surgical skills of pediatric surgical trainees. Read More

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February 2021

Assessing the benefit of reoperations in patients who suffer from fecal incontinence after repair of their anorectal malformation.

J Pediatr Surg 2020 Oct 17;55(10):2159-2165. Epub 2020 Jun 17.

Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, Columbus, OH.

Background And Aim: Patients with a previously repaired anorectal malformation (ARM) can suffer from complications which lead to incontinence. Reoperation can improve the anatomic result, but its impact on functional outcomes is unclear.

Methods: We performed a retrospective cohort study of patients with a previously repaired ARM who underwent redo PSARP at our Center and compared results at initial assessment and 12 months after redo. Read More

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October 2020

Imaged-guided and muscle sparing laparoscopic anorectoplasty using real-time magnetic resonance imaging.

Pediatr Surg Int 2020 Oct 7;36(10):1255-1260. Epub 2020 Jul 7.

Section of Pediatric Surgery, Department of Surgery, Mott Children's Hospital, University of Michigan, 1540 East Hospital Drive, SPC 4211, Ann Arbor, MI, 48109-4211, USA.

A challenge when repairing imperforate anus is positioning the neo-rectum into the center of the sphincter muscle complex (SMC) with limited muscle injury and scarring. Unfortunately, the path through the components of the SMC are often non-linear. We have used MRI to delineate the complex and guide the needle through the center using standard MRI-guidance (Raschbaum GR et al. Read More

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October 2020

Transanal rectal mucosectomy and muscular plication: A new technique for rectal prolapse in patients with an anorectal malformation.

J Pediatr Surg 2020 Nov 29;55(11):2531-2535. Epub 2020 May 29.

Centro Colorrectal para Niños de México y Latinoamérica, Hospital Ángeles Puebla, Mexico.

Background: Rectal prolapse after repair of an anorectal malformation (ARM) occurs at a frequency of 3.8% to 60.0%. Read More

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November 2020

A Surgical Technique to Repair Perineal Body Disruption Secondary to Sexual Assault.

European J Pediatr Surg Rep 2020 Jan 28;8(1):e27-e31. Epub 2020 Apr 28.

Department of Paediatric Surgery, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa.

Perineal trauma is uncommon in the pediatric population and it is estimated that 5 to 21% is secondary to sexual abuse. We aim to present a proposed surgical technique to repair perineal injuries secondary to sexual assault in female children. The technique is based on the posterior sagittal anorectoplasty (PSARP) for repairing anorectal malformations and, between 2017 and 2019, it was used to treat three girls (2 months, 2 years, and 8 years of age) with fourth-degree perineal injuries secondary to sexual assault. Read More

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January 2020

Atypical rectoscrotal and rectoperineal fistula in male anorectal malformations: a case series of non-detaching strategies for preventing urethral injury.

Pediatr Surg Int 2020 Jul 12;36(7):845-851. Epub 2020 May 12.

Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.

Anorectal malformations (ARM) represent a broad spectrum of patients with different level of the rectum and type of a fistula. Standardized approaches are usually successful, but patients occasionally present with an unusual course of fistula which requires a modified surgical strategy. We present here three male ARM patients with an atypical fistula which did not have connection with the urinary tract, but ran near the fistula. Read More

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General complications after surgery for anorectal malformations.

Pediatr Surg Int 2020 Apr 21;36(4):431-445. Epub 2020 Feb 21.

Department of Pediatric Surgery, Faculty of Medicine, Ege University, Izmir, Turkey.

The introduction of posterior sagittal anorectoplasty (PSARP) by deVries and Peña in the early 80s has impacted to the treatment of patients with anorectal malformations (ARM). It gained great recognition worldwide in a very short time, and since then, surgeons dealing with the treatment of this complex malformation could achieve tremendous progress in contemporary management of this anomaly. Despite the growing experience and body of information globally, the treatment of ARMs continues to be a challenge to the pediatric surgeons due to the nature and the variability of the anomaly, and short- and long-term problems continue to exist even after nearly 40 years of the PSARP era. Read More

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Devastating Outcomes of Traditional Enemas: Unusual Indications for Well-Known Operations.

European J Pediatr Surg Rep 2020 Jan 8;8(1):e3-e6. Epub 2020 Feb 8.

Department of Paediatric Surgery, Chris Hani Baragwanath Hospital, Johannesburg, Gauteng, South Africa.

 Despite serious health risks having been described, traditional enemas are still often used in African traditional medicine. We aim to report two cases of complications secondary to traditional enemas, to illustrate how severe the injuries can be, and to describe the use of a Swenson type endoanal pull-through and a posterior sagittal anorectoplasty (PSARP) as surgical options.  A 2-year-old girl presented with a necrotic rectum after a traditional enema administration. Read More

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January 2020

Quality of life and defecative function 10 years or longer after posterior sagittal anorectoplasty and laparoscopic-assisted anorectal pull-through for anorectal malformation.

Pediatr Surg Int 2020 Mar 17;36(3):289-293. Epub 2019 Dec 17.

Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong, China.

Purpose: In our center, patients with anorectal malformation, including males with recto-vesical (RV)/recto-bladder neck (RBN)/recto-prostatic urethral (RU) fistulas, and females with recto-vaginal (RV) fistulas have been treated by posterior sagittal anorectoplasty (PSARP) before 2000, and by laparoscopic-assisted anorectal pull-through (LAARP) thereafter. We would like to compare the quality of life (QOL) and long-term defecative function between these two groups of patients 10 years after reconstructive surgery.

Methods: Patients who underwent LAARP between 2001 and 2005 were compared with historical controls treated with PSARP between 1996 and 2000. Read More

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Identification of an occult recto-prostatic fistula with cystoscopy-assisted air colostogram.

Int J Surg Case Rep 2019 19;65:349-353. Epub 2019 Nov 19.

Department of Surgery, Section of Pediatric Surgery at Yale University, 333 Cedar St, FMB 131, New Haven, CT, United States. Electronic address:

Introduction: Anorectal malformations (ARM) in newborns classically present with the absence of a normal anus or an abnormally located anus. In a male infant with a high ARM, an initial diverting colostomy is later followed by a definitive posterior sagittal anorectoplasty (PSARP). Prior to definitive surgery an augmented-pressure colostogram is performed to identify the location of the fistula between the rectum and urogenital tract. Read More

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November 2019