Comparison of Posterior Sagittal Anorectoplasty (PSARP) with Laparoscopy Assisted Anorectoplasty (LAARP) in the Management of Anorectal Malformations
Anorectal malformations (ARMs) are a rare congenital disorder that predominates in male newborns. ARMs patients are born with an abnormal anal canal either partially or completely. These malformations are divided into three types based on the location of the rectal sac, namely low type, intermediate type, and high type. The most common type of ARMs in male and female is intermediate type. In male it is rectourethral fistula and in female it is rectovestibular. The diagnosis of ARMs can be made by history taking and physical examination, in which newborns will show abdominal distension, no anus and fistula can be found. In general, the management of anorectal malformations is carried out through 3 types of surgery, including perineal surgery, Posterior Sagittal Anorectoplasty (PSARP), and Laparoscopic Assisted Anorectoplasty (LAARP). Treatment options for anorectal malformations depend on their classification and degree of abnormality. PSARP is an operative procedure that is commonly used in the treatment of elevated anorectal malformations. However, laparoscopic- assisted anorectoplasty LAARP has become a new treatment adapted for the management of high and intermediate ARM patients. However, surgery with LAARP is still unclear regarding its functional benefits, so that many studies have been carried out to date regarding the effectiveness of LAARP compared to PSARP as a treatment for ARMs.
2. Ishimaru T, Kawashima H, Hayashi K, Omata K, Sanmoto Y, Inoue M. Laparoscopically assisted anorectoplasty-Surgical procedures and outcomes: A literature review. Asian J Endosc Surg 2021;14(3):335– 45.
3. Lokananta I. Tinjauan Pustaka Malformasi Anorektal. J Biospesies 2015;2:1–6.
4. Smith CA, Avansino J. Anorectal Malformations. StatPearls 2021;
5. Koga H, Ochi T, Okawada M, Doi T, Lane GJ, Yamataka A. Comparison of outcomes between laparoscopy- assisted and posterior sagittal anorectoplasties for male imperforate anus with recto-bulbar fistula. J Pediatr Surg 2014;49(12):1815–7.
6. Ming AX, Li L, Diao M, Wang H Bin, Liu Y, Ye M, et al. Long term outcomes of laparoscopic-assisted anorectoplasty: A comparison study with posterior sagittal anorectoplasty. J Pediatr Surg 2014;49(4):560–3.
7. Tainaka T, Uchida H, Tanaka Y, Hinoki A, Shirota C, Sumida W, et al. Long-term outcomes and complications after laparoscopic- assisted anorectoplasty vs. posterior sagittal anorectoplasty for high- and intermediate-type anorectal malformation. Pediatr Surg Int 2018;34(10):1111–5.
8. Zheng H, Liu G, Liang Z, Chen Y, Wen Z, Yu J, et al. Middle-term bowel function and quality of life in low-type anorectal malformation. Ital J Pediatr 2019;45(1):1–9.
9. Ren X, Xu H, Jiang Q, Diao M, Li X, Li L. Single-incision laparoscopic- assisted anorectoplasty for treating children with intermediate-type anorectal malformations an Pediatr Surg 2014;49(12):1815–7.
10. Hamzah M. Karakteristik Atresia Ani dengan Penyakit Bawaan lain yang Menyertainya di RSUP.H.Adam Malik Medan dan RSUD. Pringadi Medan Tahun 2011-2016. 2017;1(2):6–38.
11. Peña A, Bischoff A. Surgical treatment of colorectal problems in children. Surg Treat Color Probl Child 2015;1–497.
12. Wood RJ, Levitt MA. Anorectal Malformations. Clin Colon Rectal Surg 2018;31(2):61–70.
13. Levitt MA, Peña A. Anorectal malformations. Orphanet J Rare Dis 2007;2(1):1–13.
14. Gurusamy R, Raj SV, Maniam R, Regunandan SR. Laparoscopic- assisted Anorectoplasty: A Single- center Expirience. 2017;23(4):179– 81.
Copyright (c) 2022 Jurnal Kedokteran
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.