Functional Outcome and Quality of Life after Posterior Sagittal Anorectoplasty vs. Laparoscopic-Assisted Anorectal Pull-Through for High and Intermediate Anorectal Anomalies

Kasem, Hesham; Elshahat, Wael; Atia, Amira; Ismail Sabry, Mohamed; Elekiabi, Omar Atef

doi:10.21608/zumj.2025.377080.3919

Functional Outcome and Quality of Life after Posterior Sagittal Anorectoplasty vs. Laparoscopic-Assisted Anorectal Pull-Through for High and Intermediate Anorectal Anomalies

Document Type : Original Article

Authors

¹ Pediatric surgery department, Faculty of Medicine Zagazig University

² Pediatric sugery Department, faculty of medicine, zagazig university

³ Pediatric Surgery Department, Faculty of Medicine, Zagazig University

10.21608/zumj.2025.377080.3919

Abstract

Background:

Anorectal malformations (ARMs) are complex congenital anomalies requiring surgical correction. Posterior sagittal anorectoplasty (PSARP) and laparoscopic-assisted anorectal pull-through (LAARP) are the main surgical approaches for high and intermediate types. This study aims to compare the long-term functional outcomes and quality of life (QOL) between these two techniques.

Methods:

This retrospective study was conducted at the Department of Pediatric Surgery, Zagazig University, and included children with high and intermediate ARMs who underwent PSARP or LAARP between 2010 and 2019. Data were collected from hospital records, including demographics, type of anomaly, associated anomalies, surgical details, and postoperative complications. Functional outcomes were evaluated using the Krickenbeck classification, and QOL was assessed using a validated questionnaire.

Results:

A total of 46 patients were included: 24 underwent PSARP (18 males, 6 females) and 22 underwent LAARP (16 males, 6 females). There were no statistically significant differences in demographic data between the groups. The mean age at assessment was 6 years (range: 3–15 years). Voluntary bowel movements were observed in 33.3% of PSARP and 31.8% of LAARP patients. Soiling occurred in 45.8% (PSARP) and 40.9% (LAARP), while constipation was noted in 37.5% and 31.8%, respectively. QOL scores showed no significant differences, with good QOL reported in 79.1% of PSARP and 72.7% of LAARP patients.

Conclusion:

Both PSARP and LAARP yield comparable functional and quality-of-life outcomes in children with high and intermediate ARMs. The choice of procedure may be guided by surgeon preference and patient-specific factors.

Keywords: Anorectal malformation, PSARP, LAARP, functional outcome, quality of life.

Keywords