Pediatria pre prax 6/2023

Anorectal malformations (ARM) – part 1: ARM in males

Anorectal malformations (ARM) can be defined as malformations of distal gastrointestinal tract and organs of fecal continence. Good function of anorectum has a significant influence on quality of life (QoL), emphasizing that surgery for ARM has an important impact on QoL during its development in the first years of life of patients. Surgery should be performed once in a manner that allows perfect postoperative results in order to avoid reoperations, which have their limitations due to the scar formation, as well as morphological and functional changes in the affected area. Surgery for ARM is still challenging. The development of different classifications and surgical approaches throughout the history underlines the effort for the best solution in different types of ARM. The tendency of miniinvasive surgical methods has been implemented also into the colorectal surgery for ARM in the past decades. Laparoscopically assisted anorectoplasty (LAARP) is indicated in male patients with high types of ARM. Laparoscopy is safe and effective method sparing the structures of minor pelvis with positive consequences on long term postoperative course.

Keywords: atresia of anus and rectum, recto-perineal fistula, recto-urethral fistula, recto-vesical fistula (bladder neck)