ACU-GUIDED SILAARP FOR HIGH ANORECTAL MALFORMATIONS: EFFECTIVE AND RELIABLE: A NORTH AFRICAN EXPERIENCE up.urszula@gmail.com

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ACU-GUIDED SILAARP FOR HIGH ANORECTAL MALFORMATIONS: EFFECTIVE AND RELIABLE: A NORTH AFRICAN EXPERIENCE

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Maria Kamila Klimeczek-Chrapusta up.urszula@gmail.com Jagiellonian University Krakow Poland

 

 

 

United Kingdom

Oral or Poster

Single-stage laparoscopic-assisted anorectal pull-through (LAARP) is a promising alternative to the traditional three-stage approach in neonates with high anorectal malformations (ARMs). Preoperative fistula localization remains a key challenge, particularly in settings with limited access to advanced imaging.

We conducted a prospective cohort study over two years at Cairo University Specialized Paediatric Hospital, including 20 consecutive male neonates with high ARMs. Ascending cysto-urethrogram (ACU) was used preoperatively to identify the fistula. Patients with recto-bulbar were excluded. SILAARP was performed, and outcomes were followed over two years.

Eighteen of the 20 patients successfully underwent SILAARP, with a mean operative time of 103.7 minutes and a mean hospital stay of 5.3 days. ACU demonstrated 100% accuracy in fistula localization, confirmed intraoperatively. At follow-up, complications included anal stricture (10%), wound infection (10%), and one redo anoplasty. MRI confirmed correct anorectal positioning in 95% of cases.

Our findings demonstrate that SILAARP, guided by preoperative ACU, is a feasible and safe approach for male neonates with high ARMs. ACU provides a practical, cost-effective alternative to more advanced imaging modalities, making it particularly valuable in resource-limited settings.