Laparoscopic Versus Open Surgical Repair of Anorectal Malformations: A Systematic Review and Meta-Analysis
<h3 dir="ltr">Background</h3><p dir="ltr">Laparoscopic-assisted anorectoplasty (LAARP) and posterior sagittal anorectoplasty (PSARP) are established procedures for the treatment of high and intermediate anorectal malformations (ARMs). Their comparative outcomes...
محفوظ في:
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| مؤلفون آخرون: | , , , , |
| منشور في: |
2025
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| الموضوعات: | |
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إضافة وسم
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| _version_ | 1864513521668063232 |
|---|---|
| author | Amani N. Alansari (19743643) |
| author2 | Marwa Messaoud (22827959) Hanan Youssif Mohamed (22282399) Mohamed Sayed Zaazouee (10576593) Salma Mani (22047860) Ksia Amine (23740245) |
| author2_role | author author author author author |
| author_facet | Amani N. Alansari (19743643) Marwa Messaoud (22827959) Hanan Youssif Mohamed (22282399) Mohamed Sayed Zaazouee (10576593) Salma Mani (22047860) Ksia Amine (23740245) |
| author_role | author |
| dc.creator.none.fl_str_mv | Amani N. Alansari (19743643) Marwa Messaoud (22827959) Hanan Youssif Mohamed (22282399) Mohamed Sayed Zaazouee (10576593) Salma Mani (22047860) Ksia Amine (23740245) |
| dc.date.none.fl_str_mv | 2025-12-12T09:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1177/30502225251401658 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Laparoscopic_Versus_Open_Surgical_Repair_of_Anorectal_Malformations_A_Systematic_Review_and_Meta-Analysis/32034174 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Clinical sciences Paediatrics anorectal malformations ARMs laparoscopic LAARP PSARP meta-analysis |
| dc.title.none.fl_str_mv | Laparoscopic Versus Open Surgical Repair of Anorectal Malformations: A Systematic Review and Meta-Analysis |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3 dir="ltr">Background</h3><p dir="ltr">Laparoscopic-assisted anorectoplasty (LAARP) and posterior sagittal anorectoplasty (PSARP) are established procedures for the treatment of high and intermediate anorectal malformations (ARMs). Their comparative outcomes remain under investigation.</p><h3 dir="ltr">Objective</h3><p dir="ltr">To compare the outcomes of LAARP and PSARP in children with high and intermediate ARMs.</p><h3 dir="ltr">Methods</h3><p dir="ltr">PubMed, Web of Science, Scopus, and the Cochrane Library were searched from database inception up to April 2025 for prospective studies comparing LAARP and PSARP. Data were analyzed using Review Manager (RevMan) 5.4. A fixed-effect model was primarily used for data synthesis. However, a random-effects model was applied in cases of significant heterogeneity.</p><h3 dir="ltr">Results</h3><p dir="ltr">Eight studies were included, of which 6 contributed data to the quantitative synthesis. LAARP demonstrated significantly better functional continence scores than PSARP at 1-year follow-up (SMD = 0.58; 95% CI: 0.08-1.08; <i>P</i> = .02; <i>I</i><sup><em>2</em></sup> = 34%). Operative time was longer in the LAARP group, though not statistically significant (MD = 133.16 minutes; 95% CI: −26.45 to 292.77; <i>P</i> = .10; <i>I</i><sup><em>2</em></sup> = 96%). The length of hospital stay was significantly shorter in the LAARP group (MD = −3.45 days; 95% CI: −4.47 to −2.61; <i>P</i> < .00001; <i>I</i><sup><em>2</em></sup> = 54%). LAARP was associated with potentially higher rates of anal stenosis (RR = 1.48; 95% CI: 0.62-3.55; <i>P</i> = .38; <i>I</i><sup><em>2</em></sup> = 4%) and rectal prolapse (RR = 2.15; 95% CI: 0.84-5.48; <i>P</i>= .11; <i>I</i><sup><em>2</em></sup> = 9%), though differences did not reach statistical significance.</p><h3 dir="ltr">Conclusion</h3><p dir="ltr">LAARP offers improved short-term continence and shorter hospital stay compared with PSARP in children with high and intermediate ARMs. Further large multicenter randomized trials with long-term follow-up are needed to confirm these findings.</p><h2 dir="ltr">Other Information</h2><p dir="ltr">Published in: Sage Open Pediatrics<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1177/30502225251401658" target="_blank">https://dx.doi.org/10.1177/30502225251401658</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_f9d732592dd565951390c8f57b3e337b |
| identifier_str_mv | 10.1177/30502225251401658 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/32034174 |
| publishDate | 2025 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Laparoscopic Versus Open Surgical Repair of Anorectal Malformations: A Systematic Review and Meta-AnalysisAmani N. Alansari (19743643)Marwa Messaoud (22827959)Hanan Youssif Mohamed (22282399)Mohamed Sayed Zaazouee (10576593)Salma Mani (22047860)Ksia Amine (23740245)Biomedical and clinical sciencesClinical sciencesPaediatricsanorectal malformationsARMslaparoscopicLAARPPSARPmeta-analysis<h3 dir="ltr">Background</h3><p dir="ltr">Laparoscopic-assisted anorectoplasty (LAARP) and posterior sagittal anorectoplasty (PSARP) are established procedures for the treatment of high and intermediate anorectal malformations (ARMs). Their comparative outcomes remain under investigation.</p><h3 dir="ltr">Objective</h3><p dir="ltr">To compare the outcomes of LAARP and PSARP in children with high and intermediate ARMs.</p><h3 dir="ltr">Methods</h3><p dir="ltr">PubMed, Web of Science, Scopus, and the Cochrane Library were searched from database inception up to April 2025 for prospective studies comparing LAARP and PSARP. Data were analyzed using Review Manager (RevMan) 5.4. A fixed-effect model was primarily used for data synthesis. However, a random-effects model was applied in cases of significant heterogeneity.</p><h3 dir="ltr">Results</h3><p dir="ltr">Eight studies were included, of which 6 contributed data to the quantitative synthesis. LAARP demonstrated significantly better functional continence scores than PSARP at 1-year follow-up (SMD = 0.58; 95% CI: 0.08-1.08; <i>P</i> = .02; <i>I</i><sup><em>2</em></sup> = 34%). Operative time was longer in the LAARP group, though not statistically significant (MD = 133.16 minutes; 95% CI: −26.45 to 292.77; <i>P</i> = .10; <i>I</i><sup><em>2</em></sup> = 96%). The length of hospital stay was significantly shorter in the LAARP group (MD = −3.45 days; 95% CI: −4.47 to −2.61; <i>P</i> < .00001; <i>I</i><sup><em>2</em></sup> = 54%). LAARP was associated with potentially higher rates of anal stenosis (RR = 1.48; 95% CI: 0.62-3.55; <i>P</i> = .38; <i>I</i><sup><em>2</em></sup> = 4%) and rectal prolapse (RR = 2.15; 95% CI: 0.84-5.48; <i>P</i>= .11; <i>I</i><sup><em>2</em></sup> = 9%), though differences did not reach statistical significance.</p><h3 dir="ltr">Conclusion</h3><p dir="ltr">LAARP offers improved short-term continence and shorter hospital stay compared with PSARP in children with high and intermediate ARMs. Further large multicenter randomized trials with long-term follow-up are needed to confirm these findings.</p><h2 dir="ltr">Other Information</h2><p dir="ltr">Published in: Sage Open Pediatrics<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1177/30502225251401658" target="_blank">https://dx.doi.org/10.1177/30502225251401658</a></p>2025-12-12T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1177/30502225251401658https://figshare.com/articles/journal_contribution/Laparoscopic_Versus_Open_Surgical_Repair_of_Anorectal_Malformations_A_Systematic_Review_and_Meta-Analysis/32034174CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/320341742025-12-12T09:00:00Z |
| spellingShingle | Laparoscopic Versus Open Surgical Repair of Anorectal Malformations: A Systematic Review and Meta-Analysis Amani N. Alansari (19743643) Biomedical and clinical sciences Clinical sciences Paediatrics anorectal malformations ARMs laparoscopic LAARP PSARP meta-analysis |
| status_str | publishedVersion |
| title | Laparoscopic Versus Open Surgical Repair of Anorectal Malformations: A Systematic Review and Meta-Analysis |
| title_full | Laparoscopic Versus Open Surgical Repair of Anorectal Malformations: A Systematic Review and Meta-Analysis |
| title_fullStr | Laparoscopic Versus Open Surgical Repair of Anorectal Malformations: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Laparoscopic Versus Open Surgical Repair of Anorectal Malformations: A Systematic Review and Meta-Analysis |
| title_short | Laparoscopic Versus Open Surgical Repair of Anorectal Malformations: A Systematic Review and Meta-Analysis |
| title_sort | Laparoscopic Versus Open Surgical Repair of Anorectal Malformations: A Systematic Review and Meta-Analysis |
| topic | Biomedical and clinical sciences Clinical sciences Paediatrics anorectal malformations ARMs laparoscopic LAARP PSARP meta-analysis |