52 -10 (60) 2023 — Koynov Yu.Yu., Gramzin A.V. — OUTCOMES OF TREATMENT OF ANORECTAL MALFORMATIONS IN CHILDREN

OUTCOMES OF TREATMENT OF ANORECTAL MALFORMATIONS IN CHILDREN

Koynov Yu.Yu., State Novosibirsk Regional Clinical Hospital

Gramzin A.V., State Novosibirsk Regional Clinical Hospital, Novosibirsk State Medical University of the Ministry of Health of Russia

Krivosheenko N.V., State Novosibirsk Regional Clinical Hospital

Pavlushin P.M., State Novosibirsk Regional Clinical Hospital, Novosibirsk State Medical University of the Ministry of Health of Russia

Tsyganok V.N., State Novosibirsk Regional Clinical Hospital

Oxotina A.A., State Novosibirsk Regional Clinical Hospital

Tratonin A.A., State Novosibirsk Regional Clinical Hospital, Novosibirsk State Medical University of the Ministry of Health of Russia

Trushin P.V. State Novosibirsk Regional Clinical Hospital, Novosibirsk State Medical University of the Ministry of Health of Russia

Resume

The purpose of this study is to analyze the results of treatment of children with anorectal malformations. Anorectal malformations (ARM) include a large range of defects affecting the anal canal, rectum, and genitourinary system, occurring 1:2000-5000 newborns.

Materials and methods: From 2017 to 2022, 57 children with various forms of ARM were treated in the pediatric surgical department of the Novosibirsk Regional Clinical Hospital (boys – 32; girls – 25). Primary anorectoplasty was performed in 32 patients with low forms of ARM. 25 children underwent three-stage repair. Results: Postoperative complications in patients with one-stage repair were diagnosed in 3 (9.3%), and 10 (30%) patients had complications after three-stage surgical treatment. When comparing groups of children with low forms of ARM, where both three- stage and one-stage repair was performed, and children with high forms with preventive colostomy and one-stage repair, differences in preoperative preparation, duration of TPN and catheterization of the bladder were revealed. More thorough preparation of the intestines in children before one-stage surgical treatment and TPN reduced the risks of postoperative complications.Conclusions. One-stage repair of low forms of anorectal malformations, in our study, proved to be effective in all patients with a minimum of postoperative complications. Staged surgical treatment in children with high forms of ARM is justified and appropriate.

Keywords: anorectal malformations, perineal fistula, vestibular fistula, one-stage repair, posterior sagittal approach.

First page

304

Last page

310

For citation: Koynov Yu.Yu., Gramzin A.V., Krivosheenko N.V., Pavlushin P.M., Tsyganok V.N., Oxotina A.A., Tratonin A.A., Trushin P.V. – OUTCOMES OF TREATMENT OF ANORECTAL MALFORMATIONS IN CHILDREN //New Day in Medicine 2023 10(60): 304-310 https://newdaymedicine.com/index.php/2023/10/06/l-440/

LIST OF REFERENCES:

  1. Мокрушина О.Г., Щапов Н.Ф., Ватолин К.В., Гуревич А.И., Левитская М.В., Шумихин В.С., Корчагина Н.С. (2015). Ранняя одномоментная радикальная коррекция аноректальных пороков. Актуальные вопросы акушерства и гинекологии, неонатологии и неонатальной хирургии 2015;148-164.
  2. Бозоров Ш.Т., Туракулов З.Ш., Тошбоев Ш.О. Оценка эффективности одноэтапной коррекции свищевых форм аноректальных пороков развития у новорождённых. // Новый день в медицине. 2019; (4):136-139.
  3. Ahmed Elrouby Saber Waheeb Ahmed Koraitim .  Anterior sagittal anorectoplasty as a technique for the repair of female anorectal malformations: A twenty two-years-single-center experience.2020; 55(3):393-396. https://doi.org/10.1016/j.jpedsurg.2019.04.008
  4. Dewberry L., Alaniz V., Wilcox D.T.  From Prenatal Diagnosis Through Transition to Adult Care: What Everyone Should Know About Anorectal Malformations. Curr. Treat. Options Peds. 2020; 6:91.
  5. Christopher W. Marenco Samuel Rice-Townsend Michael Rollins Richard J. Wood Casey Calkins Caitlin Smith. 30-day postoperative outcomes of neonatal versus delayed anoplasty for perineal and vestibular fistulas. // Journal of Pediatric Surgery. 2021;56(8):1454–1458.
  6. Giuseppe Lauriti , Dacia Di Renzo, Pierluigi Lelli Chiesa, Augusto Zani, Agostino Pierro. One-stage repair of anorectal malformations in females with vestibular fistula: a systematic review and meta-analysis. // Pediatr Surg Int. 2019;35(1):77-85 http://doi: 10.1007/s00383-018-4378-2
  7. Li Yang ,Shao-tao Tang,Shuai Li, T.H. Aubdoollah, Guo-qing Cao, Hai-yan Lei. Two-stage laparoscopic approaches for high anorectal malformation: transumbilical colostomy and anorectoplasty. // Journal of Pediatric Surgery. 2014;49(11):1631–1634. https://doi.org/10.1016/j.jpedsurg.2014.05.014
  8. Shawn T. Liechty, Douglas C. Barnhart, Jordan T. Huber, Sarah Zobell, Michael D. Rollins. The morbidity of a divided stoma compared to a loop colostomy in patients with anorectal malformation. // Journal of Pediatric Surgery. 2015; 51(1):107–110. https://doi.org/10.1016/j.jpedsurg.2015.10.025
  9. Fouad Youssef, Ghaidaa Arbash, Pramod S Puligandla, Robert J Baird.  Loop versus divided colostomy for the management of anorectal malformations: a systematic review and meta-analysis. 2017;52(5):783-790. https://doi.org/10.1016/j.jpedsurg.2017.01.044
  10. Заполянский А.В., Коростелев О.Ю., Абу-Варда И.Ф., Кандратьева О.В., Свирский А.А. Первичная проктопластика у новорожденных с аноректальными пороками развития. // Медицинские новости. 2016; (7):262.
  11. Kin Wai Edwin Chan,Kim Hung Lee,Hei Yi Vicky Wong,Kit Yi Kristine Pang,Jennifer Wai Cheung Mou,Yuk Him Tam . Outcome of patients after single-stage repair of perineal fistula without colostomy according to the Krickenbeck classification. 2014;49(8):1237-1241. https://doi.org/10.1016/j.jpedsurg.2013.11.054
  12. Scott S. Short Brian T. Bucher Douglas C. Barnhart Nadia Van Der Watt Sarah Zobell Ashley Allen.  Single-stage repair of rectoperineal and rectovestibular fistulae can be safely delayed beyond the neonatal period. // Journal of Pediatric Surgery.2018; 53(11):2174–2177 https://doi.org/10.1016/j.jpedsurg.2018.02.048
  13. Dorothy V. Rocourt, Audrey S. Kulaylat Afif N. Kulaylat Stephan Leung ,Robert E. Cilley.  Primary posterior sagittal anorectoplasty outcomes for rectovestibular and perineal fistulas using an accelerated pathway: a single institution study. // Journal of pediatric surgery. 2019;54(9):1778–1781. https://doi.org/10.1016/j.jpedsurg.2019.05.020
  14. O. D. Osifo, T O Osagie, E.O. Udefiagbon.  Outcome of primary posterior sagittal anorectoplasty of high anorectal malformation in well selected neonates.  // Niger journal clinical practice. 2014;17(1):1-5. http/doi/10.4103/1119-3077.122821
  15. Krista Lai, Angela Hargis-Villanueva, Cristine S Velazco, Erica M Weidler, Erin M Garvey, Kathleen van Leeuwen, Justin Lee.  Early postoperative feeding in single-stage repair of anorectal malformation with vestibular or perineal fistula is not associated with increased wound complications. // Journal of Pediatric Surgery. Published online: July 13, 2022. https://doi.org/10.1016/j.jpedsurg.2022.07.009
  16. Naima Zamir, Naima Rasool. The early outcome of primary anterior sagittal approach for low anorectal malformations in female patients.  // Pak. J Med Sci. 2020;36(3):456-460. https://doi: 10.12669/pjms.36.3.1503
  17. Amr Abdelhamid AbouZeid, Moustafa Mohamed Bayoumi, Mona M Abo El-Ela.  Anorectal anomalies in the female: Highlights on surgical management. // Journal of Pediatric Surgery. 2021;56(9):1570-1575. https://doi.org/10.1016/j.jpedsurg.2020.09.009
  18. Zhou Yan, Shiru Ye, Changzhen Yang, Ruyue Gao, An-Xiao Ming, Mei Diao, Long Li. One-stage versus staged laparoscopic-assisted anorectoplasty for high-and intermediate anorectal malformations: Medium-term outcomes from a propensity score matching analysis. // Journal of Pediatric Surgery. 2022; 57(11):555 – 560. http://doi.org/10.1016/j.jpedsurg.2022.01.018
  19. Аверин В.И., Ионов А.Л., Караваева С.А., Комиссаров И.А., Котин А.Н., Мокрушина О.Г., Морозов Д.А., Николаев В.В., Новожилов В.А., Поддубный И.В., Смирнов А.Н., Пименова Е.С., Окулов, Е. А. Аноректальные мальформации у детей (федеральные клинические рекомендации). // Детская хирургия, 2020;19(4):29-35.
  20. Irfan, Ahmer et al. Comparing 30-day outcomes between early versus delayed repair of anorectal malformations with perineal or rectovestibular fistulas: An analysis of the ACS NSQIP-Pediatric database. // Journal of Pediatric Surgery.2020; 56(5):979 – 983. http://doi.org/10.1016/j.jpedsurg.2020.09.002

file

download