Advances in pediatric surgery
- Volume 8 Issue 2
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- Pages.119-125
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- 2002
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- 2635-8778(pISSN)
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- 2635-8786(eISSN)
Pena Operation as a Redo Procedure for Anorectal Malformation
항문직장기형 재 수술로서 Pena술식
- Lee, Jong-Won (Department of Pediatric Surgery, Seoul National University Children's Hospital, Department of Surgery, College of Medicine, Seoul National University) ;
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Kim, Hyun-Young
(Department of Pediatric Surgery, Seoul National University Children's Hospital, Department of Surgery, College of Medicine, Seoul National University) ;
- Choi, Seung-Eun (Department of Pediatric Surgery, Seoul National University Children's Hospital, Department of Surgery, College of Medicine, Seoul National University) ;
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Jung, Seung-Eun
(Department of Pediatric Surgery, Seoul National University Children's Hospital, Department of Surgery, College of Medicine, Seoul National University) ;
- Lee, Seong-Cheol (Department of Pediatric Surgery, Seoul National University Children's Hospital, Department of Surgery, College of Medicine, Seoul National University) ;
- Park, Kwi-Won (Department of Pediatric Surgery, Seoul National University Children's Hospital, Department of Surgery, College of Medicine, Seoul National University) ;
- Kim, Woo-Ki (Department of Pediatric Surgery, Seoul National University Children's Hospital, Department of Surgery, College of Medicine, Seoul National University)
- 이종원 (서울대학교 병원 소아외과 및 의과대학 외과학교실) ;
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김현영
(서울대학교 병원 소아외과 및 의과대학 외과학교실) ;
- 최승은 (서울대학교 병원 소아외과 및 의과대학 외과학교실) ;
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정성은
(서울대학교 병원 소아외과 및 의과대학 외과학교실) ;
- 이성철 (서울대학교 병원 소아외과 및 의과대학 외과학교실) ;
- 박귀원 (서울대학교 병원 소아외과 및 의과대학 외과학교실) ;
- 김우기 (서울대학교 병원 소아외과 및 의과대학 외과학교실)
- Published : 2002.12.30
Abstract
The aim of this study was to evaluate the posterior sagittal anorectoplasty (PSARP) as a re-do operation in patients who failed initial repair of anorectal malformation. Nine patients (4 boys and 5 girls) who had previous failed surgery for anorectal malformation underwent secondary operations through posterior sagittal approach. The main reasons of surgery were constipation (n=3) and persistent anatomical derangement in spite of previous correction surgery (n=6). In addition to constipation, the former group (n=3) had various anatomical defects, and the latter group (n=6), of course, had constipation in some degrees. Patients ranged in age from 2 to 19 years (median 3 years) with only one over the age of 6 years. The primary procedures included PSARP (n=8) and anoplasty (n=1). The rectum was mobilized from surrounding structures through posterior sagittal approach and anatomical defects were corrected. The rectum underwent reconstruction, which involved relocation of the rectum and anus within the limits of the intact muscle complex. Patients underwent follow-up for periods ranging from 6 to 77 months (mean 37 months) after surgery. Anatomical corrections of all the defects were successfully fulfilled in 9 patients. All the patients were satisfied with the functional results after redo-PSARP compared with the preoperative defecatory function. This study suggests that (1) some of the patients with troublesome constipation may have anatomical defects, prominent or hidden, (2) surgeons should suspect the possibility of anatomical defect as the cause of incontinence and (3) preoperative thorough investigation to reveal the anatomical defects should be included in estimating patients with severe incontinence after previous surgery and planning the correction for failed previous surgery as well.