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

G. Aad, B. Abbott, J. Abdallah, A. A. Abdelalim, A. Abdesselam, O. Abdinov, B. Abi, M. Abolins, H. Abramowicz, H. Abreu, E. Acerbi, B. S. Acharya, D. L. Adams, T. N. Addy, J. Adelman, M. Aderholz, S. Adomeit, P. Adragna, T. Adye, S. Aefsky & 31 others J. A. Aguilar-Saavedra, M. Aharrouche, S. P. Ahlen, F. Ahles, A. Ahmad, M. Ahsan, G. Aielli, T. Akdogan, T. P.A. Åkesson, G. Akimoto, A. V. Akimov, A. Akiyama, M. S. Alam, M. A. Alam, J. Albert, S. Albrand, M. Aleksa, I. N. Aleksandrov, F. Alessandria, C. Alexa, G. Alexander, G. Alexandre, T. Alexopoulos, M. Alhroob, M. Aliev, G. Alimonti, V. Büscher, F. Crescioli, B. Mindur, A. A. Nepomuceno, The ATLAS Collaboration

    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

    Fingerprint

    Fistula
    Diverticulum
    Retrospective Studies
    Prolapse
    Pathologic Constriction
    Incidence
    Anorectal Malformations

    Keywords

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

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health
    • Surgery

    Cite this

    Multicenter retrospective comparative study of laparoscopically assisted and conventional anorectoplasty for male infants with rectoprostatic urethral fistula. / Aad, G.; Abbott, B.; Abdallah, J.; Abdelalim, A. A.; Abdesselam, A.; Abdinov, O.; Abi, B.; Abolins, M.; Abramowicz, H.; Abreu, H.; Acerbi, E.; Acharya, B. S.; Adams, D. L.; Addy, T. N.; Adelman, J.; Aderholz, M.; Adomeit, S.; Adragna, P.; Adye, T.; Aefsky, S.; Aguilar-Saavedra, J. A.; Aharrouche, M.; Ahlen, S. P.; Ahles, F.; Ahmad, A.; Ahsan, M.; Aielli, G.; Akdogan, T.; Åkesson, T. P.A.; Akimoto, G.; Akimov, A. V.; Akiyama, A.; Alam, M. S.; Alam, M. A.; Albert, J.; Albrand, S.; Aleksa, M.; Aleksandrov, I. N.; Alessandria, F.; Alexa, C.; Alexander, G.; Alexandre, G.; Alexopoulos, T.; Alhroob, M.; Aliev, M.; Alimonti, G.; Büscher, V.; Crescioli, F.; Mindur, B.; Nepomuceno, A. A.; The ATLAS Collaboration.

    In: Journal of Pediatric Surgery, Vol. 48, No. 12, 01.12.2013, p. 2383-2388.

    Research output: Contribution to journalArticle

    Aad, G, Abbott, B, Abdallah, J, Abdelalim, AA, Abdesselam, A, Abdinov, O, Abi, B, Abolins, M, Abramowicz, H, Abreu, H, Acerbi, E, Acharya, BS, Adams, DL, Addy, TN, Adelman, J, Aderholz, M, Adomeit, S, Adragna, P, Adye, T, Aefsky, S, Aguilar-Saavedra, JA, Aharrouche, M, Ahlen, SP, Ahles, F, Ahmad, A, Ahsan, M, Aielli, G, Akdogan, T, Åkesson, TPA, Akimoto, G, Akimov, AV, Akiyama, A, Alam, MS, Alam, MA, Albert, J, Albrand, S, Aleksa, M, Aleksandrov, IN, Alessandria, F, Alexa, C, Alexander, G, Alexandre, G, Alexopoulos, T, Alhroob, M, Aliev, M, Alimonti, G, Büscher, V, Crescioli, F, Mindur, B, Nepomuceno, AA & The ATLAS Collaboration 2013, 'Multicenter retrospective comparative study of laparoscopically assisted and conventional anorectoplasty for male infants with rectoprostatic urethral fistula', Journal of Pediatric Surgery, vol. 48, no. 12, pp. 2383-2388. https://doi.org/10.1016/j.jpedsurg.2013.08.010
    Aad, G. ; Abbott, B. ; Abdallah, J. ; Abdelalim, A. A. ; Abdesselam, A. ; Abdinov, O. ; Abi, B. ; Abolins, M. ; Abramowicz, H. ; Abreu, H. ; Acerbi, E. ; Acharya, B. S. ; Adams, D. L. ; Addy, T. N. ; Adelman, J. ; Aderholz, M. ; Adomeit, S. ; Adragna, P. ; Adye, T. ; Aefsky, S. ; Aguilar-Saavedra, J. A. ; Aharrouche, M. ; Ahlen, S. P. ; Ahles, F. ; Ahmad, A. ; Ahsan, M. ; Aielli, G. ; Akdogan, T. ; Åkesson, T. P.A. ; Akimoto, G. ; Akimov, A. V. ; Akiyama, A. ; Alam, M. S. ; Alam, M. A. ; Albert, J. ; Albrand, S. ; Aleksa, M. ; Aleksandrov, I. N. ; Alessandria, F. ; Alexa, C. ; Alexander, G. ; Alexandre, G. ; Alexopoulos, T. ; Alhroob, M. ; Aliev, M. ; Alimonti, G. ; Büscher, V. ; Crescioli, F. ; Mindur, B. ; Nepomuceno, A. A. ; The ATLAS Collaboration. / Multicenter retrospective comparative study of laparoscopically assisted and conventional anorectoplasty for male infants with rectoprostatic urethral fistula. In: Journal of Pediatric Surgery. 2013 ; Vol. 48, No. 12. pp. 2383-2388.
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    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.",
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    author = "G. Aad and B. Abbott and J. Abdallah and Abdelalim, {A. A.} and A. Abdesselam and O. Abdinov and B. Abi and M. Abolins and H. Abramowicz and H. Abreu and E. Acerbi and Acharya, {B. S.} and Adams, {D. L.} and Addy, {T. N.} and J. Adelman and M. Aderholz and S. Adomeit and P. Adragna and T. Adye and S. Aefsky and Aguilar-Saavedra, {J. A.} and M. Aharrouche and Ahlen, {S. P.} and F. Ahles and A. Ahmad and M. Ahsan and G. Aielli and T. Akdogan and {\AA}kesson, {T. P.A.} and G. Akimoto and Akimov, {A. V.} and A. Akiyama and Alam, {M. S.} and Alam, {M. A.} and J. Albert and S. Albrand and M. Aleksa and Aleksandrov, {I. N.} and F. Alessandria and C. Alexa and G. Alexander and G. Alexandre and T. Alexopoulos and M. Alhroob and M. Aliev and G. Alimonti and V. B{\"u}scher and F. Crescioli and B. Mindur and Nepomuceno, {A. A.} and {The ATLAS Collaboration}",
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    TY - JOUR

    T1 - Multicenter retrospective comparative study of laparoscopically assisted and conventional anorectoplasty for male infants with rectoprostatic urethral fistula

    AU - Aad, G.

    AU - Abbott, B.

    AU - Abdallah, J.

    AU - Abdelalim, A. A.

    AU - Abdesselam, A.

    AU - Abdinov, O.

    AU - Abi, B.

    AU - Abolins, M.

    AU - Abramowicz, H.

    AU - Abreu, H.

    AU - Acerbi, E.

    AU - Acharya, B. S.

    AU - Adams, D. L.

    AU - Addy, T. N.

    AU - Adelman, J.

    AU - Aderholz, M.

    AU - Adomeit, S.

    AU - Adragna, P.

    AU - Adye, T.

    AU - Aefsky, S.

    AU - Aguilar-Saavedra, J. A.

    AU - Aharrouche, M.

    AU - Ahlen, S. P.

    AU - Ahles, F.

    AU - Ahmad, A.

    AU - Ahsan, M.

    AU - Aielli, G.

    AU - Akdogan, T.

    AU - Åkesson, T. P.A.

    AU - Akimoto, G.

    AU - Akimov, A. V.

    AU - Akiyama, A.

    AU - Alam, M. S.

    AU - Alam, M. A.

    AU - Albert, J.

    AU - Albrand, S.

    AU - Aleksa, M.

    AU - Aleksandrov, I. N.

    AU - Alessandria, F.

    AU - Alexa, C.

    AU - Alexander, G.

    AU - Alexandre, G.

    AU - Alexopoulos, T.

    AU - Alhroob, M.

    AU - Aliev, M.

    AU - Alimonti, G.

    AU - Büscher, V.

    AU - Crescioli, F.

    AU - Mindur, B.

    AU - Nepomuceno, A. A.

    AU - The ATLAS Collaboration

    PY - 2013/12/1

    Y1 - 2013/12/1

    N2 - 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.

    AB - 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.

    KW - High imperforate anus

    KW - Laparoscopy

    KW - Male infant

    KW - Multicenter retrospective comparative study

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    U2 - 10.1016/j.jpedsurg.2013.08.010

    DO - 10.1016/j.jpedsurg.2013.08.010

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    EP - 2388

    JO - Journal of Pediatric Surgery

    JF - Journal of Pediatric Surgery

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