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CC BY 4.0 · Eur J Pediatr Surg 2023; 33(05): 345-353
DOI: 10.1055/s-0042-1758152
Review Article

Outcomes after Surgical Treatment for Rectal Atresia in Children: Is There a Preferred Approach? A Systematic Review

Cunera M. C. de Beaufort 
1   Department of Pediatric Surgery, Emma Children's Hospital Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
2   Amsterdam Gastroenterology and Metabolism Research Institute, Amsterdam, the Netherlands
3   Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
,
Joep P. M. Derikx
1   Department of Pediatric Surgery, Emma Children's Hospital Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
2   Amsterdam Gastroenterology and Metabolism Research Institute, Amsterdam, the Netherlands
3   Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
,
Justin R. de Jong
1   Department of Pediatric Surgery, Emma Children's Hospital Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
2   Amsterdam Gastroenterology and Metabolism Research Institute, Amsterdam, the Netherlands
3   Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
,
George L. Burchell
4   Department of Medical Library, Amsterdam University Medical Center, Vrije Universiteit of Amsterdam, Medical Library, Amsterdam, the Netherlands
,
Sterre R. J. Bosscha
1   Department of Pediatric Surgery, Emma Children's Hospital Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
,
Sjoerd A. de Beer
1   Department of Pediatric Surgery, Emma Children's Hospital Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
,
Lodewijk W. Ernest van Heurn
1   Department of Pediatric Surgery, Emma Children's Hospital Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
2   Amsterdam Gastroenterology and Metabolism Research Institute, Amsterdam, the Netherlands
3   Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
,
Ramon R. Gorter
1   Department of Pediatric Surgery, Emma Children's Hospital Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
2   Amsterdam Gastroenterology and Metabolism Research Institute, Amsterdam, the Netherlands
3   Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
› Author Affiliations Funding None.
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Abstract

Rectal atresia (RA) affects only 1 to 2% of all children with anorectal malformations. No consensus on optimal treatment strategy is yet achieved. Therefore, the aim of this systematic review is to summarize all surgical interventions for RA and outcomes described in the current literature. A literature search was conducted in PubMed, Embase, Web of Science, and Cochrane Library on January 24, 2022. All studies describing treatment for RA in children (< 18 years) were included. Operation technique and postoperative complications were listed. Only descriptive analysis was anticipated. Quality of the studies was assessed using Johanna Briggs Institute critical appraisal checklist for case reports and series. The search yielded 6,716 studies of which, after duplicate removal, 4,028 were excluded based on title and abstract screening. After full-text assessment, 22 of 90 studies were included, yielding 70 patients. Posterior sagittal anorectoplasty (PSARP) and pull-through were most performed (43/70 and 18/70 patients, respectively). Four patients experienced postoperative complications: anal stenosis (n = 1), anastomotic stenosis (n = 2), and death due to a pulmonary complication (n = 1). In the low-quality literature available, most patients with RA are treated with PSARP or pull-through technique. A low complication rate of both has been described but follow-up was often not mentioned. Larger well-designed studies should be performed to determine optimal treatment strategy for children with RA. This study reflects level of evidence V.

Keywords

rectal atresia - children - surgical intervention - pull-through procedure - posterior sagittal anorectoplasty

Supplementary Material



Publication History

Received: 29 June 2022

Accepted: 26 August 2022

Article published online:
14 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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