Modified Soave procedure for congenital anorectal stenosis

Objective To summarize and analyze the curative effect that modified Soave procedure treats congenital anorectal stenosis, and to discuss the accuracy of diagnosis and the surgical treatment of primary cure. Methods Retrospective analysis was performed for clinical data of 5 cases who were operated by modified Soave procedure from 2015 to 2018 and to observe the curative effect in short and long term by clinical follow-up. Results Five children of congenital anorectal stenosis achieved primary postoperative healing. Defecation was satisfactory. At 1 month postoperatively, there was no onset of enterocolitis, bleeding/leakage of anastomotic stoma, infection of muscular sleeves, urinary system infection or peritonitis. During a follow-up period of 12-37 months, there was no occurrence of constipation, obstruction syndrome, anastomotic stricture or re-hospitalization. One case developed Ⅰ° proctoptoma. At Month 3 after stopping anal expansion, the frequency of Ⅰ° proctoptoma recovered gradually. At Month 15, proctoptosia disappeared and daily defecation was normalized. One case had occasional nocturnal soiling and normal daytime defecation. Conclusions As an rare type of anorectal malformations without standardized treatments, congenital anorectal stenosis is frequently complicated with megacolon. Modified Soave procedure offers a possible primary cure by one-stage operation. A definite diagnosis is made by large intestine gas-barium sulphate double contrast radiograph. And stenotic segment is located predominantly between pubic coccyx (PC) and I lines. Key words: Anal canal; Megacolon; Modified Soave procedure; Congenital anorectal stenosis