A Comparative Study Between The Outcomes Of Laparoscopy Assisted And Posterior Sagittal Anorectoplasty In The Treatment Of Congenital Anorectal Malformations

Objective: The purpose of this research is to compare the outcomes of laparoscopic assisted anorectoplasty(LAARP)and posterior sagittal anorectoplasty(PSARP)in the treatment of congenital anorectal malformations(ARM)in male patients with rectourethral fistula(RRF).Methods: We retrospectively analyzed of 51 cases of ARM with RRF in male patients admitted from January 2012 to December 2015 in our hospital and treated by the classic three stages of surgery.Among them,21 cases were treated by LAARP and 30 cases were treated by PSARP.There were 13 cases with RVF(LAARP 6 vs PSARP 7),25 cases with RPF(LAARP 10 vs PSARP 15),13 cases with RPF(LAARP 5 vs PSARP 8).The ages at operation: LAARP group3.75±0.70 years?PSARP 3.87±0.83 years.The operating time,intraoperative bleeding,postoperative hospital stay,postoperative complications,bowel functions evaluation were compared between the two groups in the stages of anorectoplasty.Results: There were no significant difference in follow-up period,disease type distribution and sacrum ratio,the incidence of all complications and evaluation of the movement of bowel between the two groups of cases.There were significant differences in age of operation(months)(6.48±0.98 vs 4.23±1.61),intraoperative bleeding(14.77±6.02 vs20.33±5.56 ml),postoperative hospital stay(10.24±2.21 vs 14.13±2.43 days),incidence of postoperative mucosal prolapse(33.3% vs 6.67%),incidence of constipation grade 2(4.77% vs 30.0%),operating time(hours)of RVF(2.37±0.35 vs 2.76±0.26)RPF(2.10±0.26 vs 2.53±0.31)RBF(3.30±0.46 vs 2.34±0.39)between the LAARP and PSARPgroups(P <0.05).Conclusion: The functional outcomes of the two groups were equivalent.The PSARP is superior in the incidence of postoperative rectal mucosal prolapse and operating time of ARM with rectobulbar fistula(RBF)(P <0.05),and the LAARP is superior in the postoperative hospital stay,intraoperative bleeding,constipation grade 2,operating time of ARM with rectovesical fistula(RVF)and rectoprostatic fistula(RPF).The classification can be used as a reference for the selection of treatments.