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Narbaev T.T.

Tashkent Pediatric Medical Institute

Aliev M.M.

Tashkent Pediatric Medical Institute

Yuldashev A.Yu.

Tashkent State Stomatology Institute

Turaeva Zh.T.

Tashkent Pediatric Medical Institute

Morphological criteria for surgical treatment of anorectal malformations in children

Authors:

Narbaev T.T., Aliev M.M., Yuldashev A.Yu., Turaeva Zh.T.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2021;(2): 48‑52

DOI: 10.17116/hirurgia202102148

Views: 1804

Downloaded: 82

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To cite this article:

Narbaev TT, Aliev MM, Yuldashev AYu, Turaeva ZhT. Morphological criteria for surgical treatment of anorectal malformations in children. Pirogov Russian Journal of Surgery. 2021;(2):48‑52. (In Russ.)
https://doi.org/10.17116/hirurgia202102148

Подписка 2025 (Pirogov Russian Journal of Surgery)
МСФ на ЯМ
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OBJECTIVE

To improve treatment outcomes in patients with anorectal malformations via research of morphological criteria and differentiated approach to surgical correction.

MATERIAL AND METHODS

There were 37 children with various types of anorectal malformations for the period 2000—2019. We analyzed morphological features of atretic rectum wall, fistula, anastomosis with adjacent organs and skin of the perineum.

RESULTS

Morphological research of anorectal malformations made it possible to differentiate treatment strategy and explain the causes of unsatisfactory results after perineal and abdominal-perineal proctoplasty. Incidence and severity of complications, as well as early disability were reduced that significantly improved postoperative quality of life.

CONCLUSION

According to the morphological criteria, deeper mobilization of atretic rectum within at least 2.5—3 cm of the rectal «cone» with intact muscular wall is necessary. This approach was valuable to ensure adequate closure function of the rectum, prevent anal incontinence and restore normal appearance of the perineum. These achievements contributed to decrease in the incidence of admissions, redo surgeries and improvement of social adaptation in children.

Keywords:

anorectal malformations
diagnosis
histomorphology
treatment strategy

Authors:

Narbaev T.T.

Tashkent Pediatric Medical Institute

Aliev M.M.

Tashkent Pediatric Medical Institute

Yuldashev A.Yu.

Tashkent State Stomatology Institute

Turaeva Zh.T.

Tashkent Pediatric Medical Institute

Received:

07.08.2020

Accepted:

10.09.2020

List of references:

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  2. Aliev MM, Razumovsky AYu, Narbaev TT. Modified proctoperineoplasty in anorectal malformation in children. Rossijskij vestnik detskoj hirurgii, anesteziologii i reanimatologii. 2019;9(3):33-42. (In Russ.). https://doi.org/10.30946/2219-4061-2019-9-3-33-42
  3. Degtjarev JuG i dr. Congenital malformations of the anorectal region. Minsk: Izdatel’stvo «Chetyre chetverti»; 2017. (In Russ.).
  4. Narbayev TT, Tilavov UKh, Turaeva NN, Terebaev BA. Modified Stone Benson’s Perineal Proctoplastics in Low Forms of Anorectal Malformation in Children. American Journal of Medicine and Medical Sciences. 2018;8(4):66-70.  https://doi.org/10.5923/j.ajmms.20180804.03
  5. Smirnov AN, Poddubny IV. Surgical treatment of anorectal malformations in children (review of foreign literature). Surgery. 1990;8:149-155. 
  6. Lukin VV, Potapova-Vinogradova IN. Morphological characteristics of rectogenital anastomosis with a normally formed anus in girls. Pediatrija. 1983;Ju:55-58. (In Russ.).
  7. Xiao H, Huang R, Cui DX, Xiao P, Diao M, Li L. Histopathologic and immunohistochemical findings in congenital anorectal malformations. Medicine (Baltimore). 2018;97(31):e11675. https://doi.org/10.1097/MD.0000000000011675
  8. Holschneider AM (Ed). Anorectal Malformations in Children: Embryology, Diagnosis, Surgical Treatment, Follow-Up. Springer-Verlag Berlin Heidelberg.
  9. Agarwal K, Chadha R, Ahluwalia C, Debnath PR, Sharma A, Roy Choudhury S. The histopathology of congenital pouch colon associated with anorectal agenesis. Eur J Pediatr Surg. 2005;15(2):102-106.  https://doi.org/10.1055/s-2004-830346
  10. Becheanu G, Manuc M, Dumbravă M, Herlea V, Hortopan M, Costache M. The evaluation of interstitial Cajal cells distribution in non-tumoral colon disorders. Rom J Morphol Embryol. 2008;49(3):351-355. 
  11. Gangopadhyay A & Pandey V. Anorectal malformations. Journal of Indian Association of Pediatric Surgeons. 2015;20(1):10-15.  https://doi.org/10.4103/0971-9261.145438
  12. van der Putte SC. Anal and ano-urogenital malformations: a histopathological study of «imperforate anus» with a reconstruction of the pathogenesis. Pediatr Dev Pathol. 2006;9(4):280-296.  https://doi.org/10.2350/06-01-0034.1
  13. Bhatia Y, Singh S, Rattan KN, et al. Anorectal Malformations: Histomorphological and Immunohistochemical Evaluation of Neuronal Dysfunction. Journal of Neonatal Surgery. 2017;6(2):29.  https://doi.org/10.21699/jns.v6i2.559
  14. Aliev MM, Narbaev TT, Yuldashev AYu, Grishaev VV. Morphological characteristics of anorectal malformations in children. Problemy biologii i mediciny, Samarkand. 2010;2(61):19-22. (In Russ.). https://www.sammi.uz/frontend/web/upload/files/%d0%9f%d0%91%d0%b8%d0%9c%20(61)%20%e2%84%96%202%202010.pdf
  15. Puri A, Chadha R, Choudhury SR, Garg A. Congenital pouch colon: follow-up and functional results after definitive surgery. J Pediatr Surg. 2006;41(8):1413-1419. https://doi.org/10.1016/j.jpedsurg.2006.04.017
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  17. Narbayev TT, Tilavov UKh, Turaeva NN, et al. Rehabilitation of Children with Anorectal Malformations. Progressing Aspects in Pediatrics and Neonatology. 2018;1(5):1-5.  https://doi.org/10.32474/papn.2018.01.000113

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