Home – Home – Jornals – Siberian Scientific Medical Journal 2020 number 1

The aim of the study was to
assess the possibility of using a surgical approach - anterior sagittal
anoproctoplasty in children who had previously been operated with
various techniques for anorectal malformations. Material and methods.
The analysis of postoperative results was performed using a scale for
assessing the long-term results of treatment of anorectal malformations
before and after surgery. A retrospective study of the patients who was
previously operated for various forms of anorectal malformations for the
period from 2016 to 2019 in pediatric surgery department of State
Novosibirsk district hospital was performed. The early and long-term
outcomes were assessed. Results. The criteria for repeated surgical
treatment were: rectal mislocated outside of the sphincter mechanism,
low social adaptation, secondary changes from the perineum and external
genital organs. After investigation (identification of the sphincter
mechanism using a myostimulator, irrigoscopy, MRI or MSCT of the pelvic
organs), all patients underwent surgical correction - the anterior
sagittal anoproctoplasty. Postoperative results were assessed using
Holschneider score. The results obtained in the course of this study
indicate the possibility of using this method of surgical treatment.
Discussion. Children previously underwent surgery for anorectal
malformations but having severe functional disorders in the anorectal
region, are a complex group of patients who must be determined specific
criteria for the reoperations need. The efficiency of surgical treatment
depends on the presence of associated congenital malformations
(myelodysplasia, pathology of the sacrum and tailbone), as well as the
severity of cicatricial changes in the sphincter mechanism. Surgical
intervention in 33.3 % of cases led to satisfactory and in 66.7 % of
cases to good results.