Objective To compare the efficacy of Laparoscopic-assisted anorectoplasty(LAARP) and Posterior sagittal anorectoplasty(PSARP) with Total urogenital mobilization(TUM) for high-and intermediate-type Persistent Cloaca(PC) by vertical comparison.Methods Twenty-five girls with high-and intermediate-type PC who underwent LAARP between November 2005 and March 2016 were retrospectively analyzed. Data of 9 girls with high-and intermediate-type PC who underwent PSARP plus TUM between March 1999 and May 2004 were collected as control. The duration of operation, estimated blood loss, postoperative hospital stay, complications and anal function(Krickenbeck classifiction) were compared between groups.Results The 2 groups were comparable in baseline data.LAARP group presented shorter operative time[(124.32±8.74)min vs.(186.67±65.53)min,P<0.05], less estimated blood loss [(15.84±9.80)ml vs.(42.78±24.25)ml,P<0.05],shorted postoperative hospital stay[(6.32±1.11)d vs.(10.11±1.90)d,P<0.05] and lower morbidity of postoperative complication[ 16.0%(4/25) vs.66.7%(6/9),P<0.05] when compared with PSARP group. According to Krickenbeck classification, the overall bowel function score of LAARP group was better than that of PSARP group[(10.39±1.50) vs.(8.89±1.54),P<0.05],children in LAARP group had better constipation score than those in PSARP group(P<0.05), however, the rates of voluntary bowel movement and soiling were similar in two groups(P>0.05).Conclusion Compared with PSARP combined with TUM, LAARP is safe effective in the treatment of high-and intermediate-type PC. Meanwhile, LAARP technique can acquire some advantages such as less traumatic, better cosmetic results and faster recovery;it seems to be more suitable for the treatment of children with high-and intermediate-type PC.
Journal of Clinical Surgery