[Modified Mollard procedure for congenital high anorectal malformations via rectal muscle sheath of blind bag out of previous sagittal approach].

OBJECTIVE

To explore the efficacies of treating infants with congenital anorectal malformation by drawing from rectal muscle sheath of blind bag out of previous sagittal approach (modified Mollard procedure).

METHODS

Retrospective analyses of postoperative anus control and bowel movements were conducted for 172 patients with high anorectal malformation. The procedures included modified Mollard (n = 68, modified group), Pena (n = 64, Pena group) and abdominal perineal anus forming (n = 40, abdominoperineal group). The tensions of external sphincter and puborectalis were gauged by digital rectal examination and the perianal degree of fecal pollution was assessed by defecography.

RESULTS

Among them, 28 boys and 18 girls had a good postoperative control of defecation in the modified group (P = 0.004). The ratios of postoperative external anal sphincter was strong were 73.5% (50/68) and 85.9% (55/64) respectively in the modified and Pena groups and they were higher than that of abdominal perineal group at 55.0% (22/40) (both P < 0.05). The difference in the former two groups was not statistically significant (P = 0.196). The incidence of constipation in the modified group was less than that in the Pena group (13.2% (9/68) vs 31.3% (20/64), P = 0.012).

CONCLUSION

Modified Mollard procedure may avoid repeated operations, offer a better control of bowel function, ease patient suffering and improve their postoperative quality-of-life.