Purpose: The aim of this study was to compare the safety and efficacy of single-incision laparoscopic-assisted anorectoplasty (SILAARP) to that of traditional three-port laparoscopic-assisted anorectoplasty (3-PLAARP) for persistent cloaca (PC) patients with mid to high rectal pouches in midterm follow-up. Materials and Methods: A study comparing 13 SILAARPs and 12 3-PLAARPs performed by a single surgeon from November 2005 to May 2016 was presented (laparoscopy was performed for anorectoplasty, and urethra vaginoplasty was performed perineally). Data including demographics and perioperative and midterm outcomes were retrospectively compared. Operative performances between the groups were compared using the Global Operative Assessment of Laparoscopic Skills (GOALS). Results: The two groups were comparable in terms of demographics. No significant difference was observed between SILAARP and 3-PLAARP groups in terms of median operative time, transfusion rates, intraoperative complications, time to resume diet, postoperative hospital stays, and GOALS scores. Postoperative outcomes included 1 patient with incomplete intestinal obstruction (SILAARP group), 1 patient requiring intermittent catherization to remain dry (3-PLAAR group), 2 patients with occasional urine incontinence (one in each group), and 5 girls with mild mucosal prolapse (2 and 3 in the SILAARP and 3-PLAAR groups, respectively); however, these did not differ significantly between groups. Trocar-related scars of the patient who was undergoing SILAARP were almost invisible. After 18 months follow-up, the rates of soiling and constipation were similar in both groups. Conclusion: The midterm outcomes of SILAARP were comparable to those of 3-PLAARP. It appears to be a safe and effective procedure with better cosmetic results for mid to high rectal pouches in PC children.
Keywords: anorectal malformations; anorectoplasty; laparoscopic; persistent cloaca.