CHOICE OF TREATMENT TACTICS FOR ANORECTAL MALFORMATIONS

Abstract

The article presents the results of an analysis of the medical history of 120 children with various types of anorectal malformations (ARM) for the period from 2010 to 2022 (12-year period) in pediatric surgery departments. This study was a retrospective cohort analysis with prospective completion of the database since 2010. It should be noted that all children in group 1 had previously been operated on during the neonatal period (in almost all cases - not in our clinic) - they were given various types of stomas. Therefore, surgical treatment of ARM was carried out according to plan. The method of laparoscopic assisted proctoplasty developed and used in our clinic for high fistula-free and fistulous (rectourethral, rectovesical) variants of ARM was analyzed and the results obtained were compared. In this regard, we can conclude that laparoscopically-assisted techniques (in 80 patients) for radical correction of some high ARMs are a completely universal approach to their treatment, allowing all the necessary stages of the operation to be performed with quality and reliability that is not inferior to the generally accepted “open” ones (in 40 children) methods. The obtained anatomical and functional results are not inferior to the results in the comparative group. Laparoscopic operations have a number of advantages over open ones – in terms of reducing the trauma of the operation, the timing of postoperative rehabilitation and recovery, early postoperative complications (p<0,05), as well as the possibility of performing simultaneous interventions for existing concomitant developmental anomalies.