腹腔镜辅助治疗Currarino综合征的研究及中期功能评估

Translated title of the contribution: Mid-term outcomes of laparoscopic-assisted pullthrough for Currarino syndrome

Qi Li, Zhen Zhang, Qian Jiang, Yuchun Yan, Ping Xiao, Ya Ma, Long Li

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate the mid-term outcomes of laparoscopic-assisted procedure for Currarino syndrome (CS). Methods: From 2016 to 2019, 14 CS children underwent laparoscopic assisted procedure. There were 6 boys and 8 girls. Another 10 CS children undergoing a transanal approach procedure from 2013 to 2015 were adopted as control group. All cases had constipation and 4 children underwent colostomy. Anal malformations included anorectal stenosis (n=8), female rectoperineal fistula (n=3), rectovaginal fistula (n=1), male anal atresia without fistula (n=1) and male rectourethral fistula (n=1). The procedures included anoplasty (n=4), median posterior sacral detethering & duraplasty (n=3), median posterior sacral tumor enucleation, detethering & duraplasty (n=1). Among four cases of median posterior sacral tumor enucleation, two children developed rectocutaneous fistula in sacrococcygeal region postoperatively. One child underwent laparoscopic assisted pull-through without enucleation and suffered from amostomosis leak postoperatively. Four cases underwent colostomy and there were 5 familial cases. Radiograph and computed tomography (CT) demonstrated a variety of anomaly sacrum. Constrast imaging indicated dilated rectum (n=9) and rectocutaneous fistula (n=2). Pelvic magnetic resonance imaging revealed presacral masses (n=12). And lumbosacral magnetic resonance imaging depicted nervous system malformations (n=8). Results: All children successfully underwent laparoscopic operation except for one case of convertion. The mean operative duration was (90-150) min and volume of blood loss (5-50) ml. All recovered uneventfully without early complication. In control group, three children (30%) suffered from early complication. The incidence of early complication was significantly lower in laparoscopic group than that in control group (P<0.05). Bowel function was assessed for those treated for over 1 years in laparoscopic group (n=10). The mean follow-up period was (15.9±3.3)(12-22) months in laparoscopic group. In laparoscopic group, the daily number of bowel movement was (3.3±1.5)(1-6). None complained fecal incontinence. There were occasional soiling (<3 times weekly, n=4) and frequent soling (≥3 times weekly, n=1). Two complained of constipation. Significant inter-group difference existed in frequent soiling (P<0.05). However, no significant inter-group difference existed in occasional soiling or constipation. Conclusions: Laparoscopic assisted procedure is both safe and effective for CS with better functional outcomes.

Translated title of the contributionMid-term outcomes of laparoscopic-assisted pullthrough for Currarino syndrome
Original languageChinese (Traditional)
Pages (from-to)906-913
Number of pages8
JournalChinese Journal of Pediatric Surgery
Volume41
Issue number10
DOIs
StatePublished - Oct 15 2020
Externally publishedYes

Keywords

  • Currarino syndrome
  • Laparoscopes

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Fingerprint Dive into the research topics of 'Mid-term outcomes of laparoscopic-assisted pullthrough for Currarino syndrome'. Together they form a unique fingerprint.

Cite this