TY - JOUR
T1 - Outcomes after Surgical Treatment for Rectal Atresia in Children
T2 - Is There a Preferred Approach? A Systematic Review
AU - de Beaufort, Cunera M. C.
AU - Derikx, Joep P. M.
AU - de Jong, Justin R.
AU - Burchell, George L.
AU - Bosscha, Sterre R. J.
AU - de Beer, Sjoerd A.
AU - van Heurn, Lodewijk W. Ernest
AU - Gorter, Ramon R.
N1 - Publisher Copyright: © 2022 Georg Thieme Verlag. All rights reserved.
PY - 2022
Y1 - 2022
N2 - Rectal atresia (RA) affects only 1 to 2% of all children with anorectal malformations. No consensus on optimal treatment strategy is yet achieved. Therefore, the aim of this systematic review is to summarize all surgical interventions for RA and outcomes described in the current literature. A literature search was conducted in PubMed, Embase, Web of Science, and Cochrane Library on January 24, 2022. All studies describing treatment for RA in children (< 18 years) were included. Operation technique and postoperative complications were listed. Only descriptive analysis was anticipated. Quality of the studies was assessed using Johanna Briggs Institute critical appraisal checklist for case reports and series. The search yielded 6,716 studies of which, after duplicate removal, 4,028 were excluded based on title and abstract screening. After full-text assessment, 22 of 90 studies were included, yielding 70 patients. Posterior sagittal anorectoplasty (PSARP) and pull-through were most performed (43/70 and 18/70 patients, respectively). Four patients experienced postoperative complications: anal stenosis (n = 1), anastomotic stenosis (n = 2), and death due to a pulmonary complication (n = 1). In the low-quality literature available, most patients with RA are treated with PSARP or pull-through technique. A low complication rate of both has been described but follow-up was often not mentioned. Larger well-designed studies should be performed to determine optimal treatment strategy for children with RA. This study reflects level of evidence V.
AB - Rectal atresia (RA) affects only 1 to 2% of all children with anorectal malformations. No consensus on optimal treatment strategy is yet achieved. Therefore, the aim of this systematic review is to summarize all surgical interventions for RA and outcomes described in the current literature. A literature search was conducted in PubMed, Embase, Web of Science, and Cochrane Library on January 24, 2022. All studies describing treatment for RA in children (< 18 years) were included. Operation technique and postoperative complications were listed. Only descriptive analysis was anticipated. Quality of the studies was assessed using Johanna Briggs Institute critical appraisal checklist for case reports and series. The search yielded 6,716 studies of which, after duplicate removal, 4,028 were excluded based on title and abstract screening. After full-text assessment, 22 of 90 studies were included, yielding 70 patients. Posterior sagittal anorectoplasty (PSARP) and pull-through were most performed (43/70 and 18/70 patients, respectively). Four patients experienced postoperative complications: anal stenosis (n = 1), anastomotic stenosis (n = 2), and death due to a pulmonary complication (n = 1). In the low-quality literature available, most patients with RA are treated with PSARP or pull-through technique. A low complication rate of both has been described but follow-up was often not mentioned. Larger well-designed studies should be performed to determine optimal treatment strategy for children with RA. This study reflects level of evidence V.
KW - children
KW - posterior sagittal anorectoplasty
KW - pull-through procedure
KW - rectal atresia
KW - surgical intervention
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85144795059&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/36516962
UR - http://www.scopus.com/inward/record.url?scp=85144795059&partnerID=8YFLogxK
U2 - https://doi.org/10.1055/s-0042-1758152
DO - https://doi.org/10.1055/s-0042-1758152
M3 - Review article
C2 - 36516962
SN - 0939-7248
JO - European journal of pediatric surgery
JF - European journal of pediatric surgery
ER -