Multicenter retrospective comparative study of laparoscopically assisted and conventional anorectoplasty for male infants with rectoprostatic urethral fistula

Atsuyuki Yamataka, Yasuhide Morikawa, Makoto Yagi, Osamu Kimura, Tatsuo Kuroda, Yutaka Kanamori, Hideaki Tanaka, Masataka Takahashi, Shigeru Ueno, Tadashi Iwanaka, Tetsuya Ishimaru, Jun Iwai, Yoshio Zaizen, Hiroyuki Koga, Ryuichi Shimono, Masayuki Kubota, Naruhiko Murase, Taro Ikeda, Akio Kubota, Keigo NaraKaori Satoh, Hizuru Amano, Shinya Takazawa, Yujiro Tanaka, Hiroo Uchida, Hiroshi Kawashima, Takahiro Jimbo, Kohji Fukumoto

    Research output: Contribution to journalArticle

    Abstract

    Background: Laparoscopically assisted anorectoplasty (LAARP) was expected to achieve better fecal continence than conventional procedures. However, the issue of which approach is better remains controversial. We compared outcomes between the conventional procedure and LAARP in male infants with rectoprostatic urethral fistula. Methods: Institutes belonging to the Japanese Study Group of Anorectal Anomalies (JSGA) were invited to participate. Subjects were male infants with rectoprostatic urethral fistula treated by the conventional approach (abdominoperineal pull-through and PSARP) or LAARP between 2000 and 2006. Medical charts and operative records were reviewed retrospectively. Results: Eighty-one patients (conventional: 36, LAARP: 45) were enrolled from 15 centers. In both groups, the mean Kelly score was 5. The total score of the scoring system was newly developed by the Japanese Study Group of Anorectal Anomalies. Follow-up Project (5-15 points) was 10.7 and 12.1 in the conventional group and the LAARP group, respectively (p = 0.07). The incidence of failed rectoanal anastomosis, mucosal prolapse, and anal stenosis was comparable in both groups. Posterior urethral diverticula were detected on cystourethrograms in 7% and 11% (p = 1.0) and on MRI in 0% and 34% (p = 0.02) of the conventional and the LAARP groups, respectively. Overall, 94% of diverticula were asymptomatic. Conclusions: Fecal continence and complication rates after LAARP were comparable to those observed after the conventional method. Posterior urethral diverticula were detected more frequently after LAARP.

    Original languageEnglish (US)
    Pages (from-to)2383-2388
    Number of pages6
    JournalJournal of Pediatric Surgery
    Volume48
    Issue number12
    DOIs
    StatePublished - Dec 1 2013

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    Keywords

    • High imperforate anus
    • Laparoscopy
    • Male infant
    • Multicenter retrospective comparative study

    ASJC Scopus subject areas

    • Surgery
    • Pediatrics, Perinatology, and Child Health

    Cite this

    Yamataka, A., Morikawa, Y., Yagi, M., Kimura, O., Kuroda, T., Kanamori, Y., Tanaka, H., Takahashi, M., Ueno, S., Iwanaka, T., Ishimaru, T., Iwai, J., Zaizen, Y., Koga, H., Shimono, R., Kubota, M., Murase, N., Ikeda, T., Kubota, A., ... Fukumoto, K. (2013). Multicenter retrospective comparative study of laparoscopically assisted and conventional anorectoplasty for male infants with rectoprostatic urethral fistula. Journal of Pediatric Surgery, 48(12), 2383-2388. https://doi.org/10.1016/j.jpedsurg.2013.08.010