Abstract

CECILIANO-ROMERO, Norma; BEAUCHAMP-CARVAJAL, Debora; CHAVEZ-FERNANDEZ, Laura  and  CORTES-OJEDA, Jaime. Analysis of 200 cases of Pediatric Anorectal Malformation. Acta méd. costarric [online]. 2010, vol.52, n.2, pp.109-117. ISSN 0001-6002.

Aim: Despite the high frequency of anorectal malformations treated at the General Surgery Service of the National Children’s Hospital, there exists a dearth of national medical publications related to this pathology. The aim of this investigation is to verify the treatment details of 200 patients who underwent anorectal surgery between 1998 and 2008 as well as to determine our experience. Any recommendations will be based on the findings of this study. Materials and methods: Two hundred patients of the Dr. Carlos Sáenz National Children’s Hospital were studied. This group presented anorectal malformations, were treated between 1998 and 2008 and received follow up care at the General Surgery outpatient clinic.The patients were grouped according to their type of anomaly and were examined for the following: associated congenital malformations, type of anorectal anomaly, type of surgery, complications and the results of the following tests: abdominal ultrasound, CUMS, distal colography and the functional results after three years of age. All of the data was collected from the patients’ medical files. This information was then transferred to an Excel data sheet for further analysis and in order to have a clear picture of the conduct that was followed with each group of patients. Results:The groups were made using the following classification: those patients with a fistula were grouped according to the location of the opening: bladder neck (12 cases), prostate (12 cases), bulbar (18 cases), vestibular (26 cases), perineal (92 cases), anal stenosis (12 cases). Those who had no fistula: high (16 cases) or low (3 cases). Finally, the cloacae malformations, both high cases (2 cases) and low cases (7cases). All of the patients underwent surgery using the Peña technique with the corresponding modifications. No patients were treated with the laparoscopic technique. Conclusion: Because we consider these cases to be highly complex, they must be studied holistically due to the fact that associated malformations bear much weight in the final results and in the morbimortality rate. In the majority of cases, satisfactory results are obtained. Long term follow up care that includes all necessary procedures, is essential in order for the patient to lead a normal life.

Keywords : anorectal malformation; cloaca; colostomy; fistula; laparoscopy; colography.

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