NEONATAL SURGERY

 

Oesophageal atresia without tracheo-oesophageal fistula and an anorectal malformation: Advantages of a primary laparoscopically assisted anorectal pull-through

 

 

M. Arnold^I; D. Sidler^II; S. W. Moore^III

^IM.B. Ch.B., D.C.H.; Division of Paediatric Surgery, Stellenbosch University and Tygerberg Children's Hospital, Tygerberg, W Cape
^IIM.D. (berne), M.Phil. (applied Ethics), F.C.S. (S.A.)Division of Paediatric Surgery, Stellenbosch University and Tygerberg Children's Hospital, Tygerberg, W Cape
^IIIM.B. Ch.B., F.R.C.S. (ed.), M.D.Division of Paediatric Surgery, Stellenbosch University and Tygerberg Children's Hospital, Tygerberg, W Cape

 

 

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ABSTRACT

We report on a primary laparoscopically assisted anorectal pull-through (LAARP) performed in a neonate with pure oesophageal atresia and imperforate anus with recto-bulbo-urethral fistula, representing a unique case for the LAARP approach owing to the undistended nature of the bowel and sterile meconium. Further evaluation of the applicability of LAARP in the management of infants with anorectal malformations is needed, but in this case it held major advantages for the patient. A laparoscopically assisted gastrostomy was facilitated during the same procedure, while avoidance of a colostomy and its associated complications also facilitated preservation of the left colon for subsequent use in oesophageal replacement. Long-term outcome remains to be assessed.

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