G Ohba, H Yamamoto, M Nakayama, S Honda, A Taketomi

Abstract

Background: The feasibility of one-stage correction for recto-bulbar anorectal malformations is unclear. We examined the complications and short-term outcomes of one-stage correction for recto-bulbar anorectal malformations in neonates. Methods: We retrospectively examined six neonates who underwent one-stage correction for recto-bulbar anorectal malformations between 2004 and 2011. We reviewed the postoperative complications and functional evaluations-via the Kelly score, Krickenbeck classification, and magnetic resonance imaging. Results: During the study period, nine neonates were diagnosed with recto-bulbar anorectal malformations. Among these, one-stage correction was performed in six patients. The recto-bulbar urethral fistulas were confirmed by urethrography. All cases underwent posterior sagittal anorectoplasty. The average Kelly score was 4.33±1.21. Using the Krickenbeck classification, one child had grade 3 constipation. Grade 3 soiling was not noted. One child had malpositioning of the rectum that was revealed by magnetic resonance imaging. Conclusions: One-stage correction for intermediate imperforate anus is feasible even during the neonatal period.

背景：一期矯正直腸球部畸形的可行性尚不清楚。我們研究了新生兒直腸球部畸形的一期矯正的併發症和短期預後。方法：我們回顧性分析了2004年至2011年間接受一期矯正的直腸球部畸形的6例新生兒。通過凱利評分、凱里肯貝克分類和磁力共振造影作出分析，我們回顧了術後併發症和功能評估。結果：在研究期間，有9名新生兒被診斷患有直腸球部畸形。其中，6例患者進行了一期的矯正。經尿道造影證實了直腸球型尿道瘺。所有病例均進行了後矢狀肛門直腸成形術。凱利平均得分為4.33±1.21。使用凱里肯貝克分類，判斷出一名嬰兒患有3級便秘。沒有3級污糞。MRI顯示一名嬰兒直腸異位。結論：即使在新生兒期，也可以對肛門閉鎖進行一期矯正。