Document Type

Article

Publication Date

8-2024

Identifier

DOI: 10.1016/j.jpedsurg.2024.04.007

Abstract

PURPOSE: Congenital anorectal stenosis is managed by dilations or operative repair. Recent studies now propose use of dilations as the primary treatment modality to potentially defer or eliminate the need for surgical repair. We aim to characterize the management and outcomes of these patients via a multi-institutional review using the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) registry.

METHODS: A retrospective database review was performed using the PCPLC registry. The patients were evaluated for demographics, co-morbidities, diagnostic work-up, surgical intervention, current bowel management, and complications.

RESULTS: 64 patients with anal or rectal stenosis were identified (57 anal, 7 rectal) from a total of 14 hospital centers. 59.6% (anal) and 42.9% (rectal) were male. The median age was 3.2 (anal) and 1.9 years (rectal). 11 patients with anal stenosis also had Currarino Syndrome with 10 of the 11 patients diagnosed with a presacral mass compared to only one rectal stenosis with Currarino Syndrome and a presacral mass. 13 patients (22.8%, anal) and one (14.3%, rectal) underwent surgical correction. Nine patients (8 anal, 1 rectal) underwent PSARP. Other procedures performed were cutback anoplasty and anterior anorectoplasty. The median age at repair was 8.4 months (anal) and 10 days old (rectal). One patient had a wound complication in the anal stenosis group. Bowel management at last visit showed little differences between groups or treatment approach.

CONCLUSION: The PCPLC registry demonstrated that these patients can often be managed successfully with dilations alone. PSARP is the most common surgical repair chosen for those who undergo surgical repair.

LEVEL OF EVIDENCE: III.

Journal Title

Journal of pediatric surgery

Volume

59

Issue

8

First Page

1652

Last Page

1656

MeSH Keywords

Humans; Male; Retrospective Studies; Female; Infant; Child, Preschool; Constriction, Pathologic; Dilatation; Registries; Anorectal Malformations; Child; Treatment Outcome; Rectum; Rectal Diseases; Anal Canal; Anus, Imperforate

Keywords

Anorectal malformation; Congenital anal stenosis; Congenital rectal stenosis; Currarino; Dilations; Presacral mass; Surgery

Comments

This article is available under the Creative Commons CC-BY-NC license and permits non-commercial use, distribution and reproduction in any medium, provided the original work is properly cited.

Publisher's Link: https://www.jpedsurg.org/article/S0022-3468(24)00258-6/fulltext

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