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Purpose <p>Rectal atresia (RA) and rectal stenosis (RS) are rare anorectal malformations (ARM), comprising 1–2% of all cases. No consensus exists regarding optimal surgical technique. This study evaluated surgical approaches, complications, and long-term functional outcomes at a single referral center.</p> Methods <p>Retrospective review of RA or RS patients treated between 2003 and 2020. Surgical technique, complications, and bowel function were analyzed. Fecal continence was assessed using Krickenbeck classification.</p> Results <p>Eleven patients were included (7 RS, 4 RA), representing 1.2% of 900 ARM cases. Surgical techniques included posterior sagittal anorectoplasty (PSARP) in 4 (36.4%), transanal in 3 (27.3%), abdominoperineal pull-through in 2 (18.2%), and laparoscopic rectal web correction (LWC) in 2 (18.2%). Two patients required redo surgery. Ten of 11 patients were eligible for functional assessment; no true fecal incontinence was observed. Five (50%) required no bowel management; constipation was identified in five, including three with overflow soiling due to non-adherence. Median follow-up was 100.4 months (range 13–168).</p> Conclusion <p>Despite surgical complexity, most patients achieved satisfactory outcomes. The high incidence of constipation, particularly in RS, underscores the need for long-term follow-up and early intervention. The laparoscopic rectal web correction offers a reproducible, sphincter-preserving technique for effective correction of rectal webs.</p>

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Challenges and outcomes in the management of rectal atresia and stenosis: a comprehensive review

  • 期刊论文

  • 发表日期：

    2026年6月15日

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  • Juan Ignacio Siffredi,
  • Lucila Álvarez,
  • María Victoria Domínguez Márquez,
  • Javier Ruíz,
  • María Daniela Neder,
  • Ana Marcela Rocca,
  • María Marcela Bailez,
  • Victor Pedro Di Benedetto

摘要

Purpose

Rectal atresia (RA) and rectal stenosis (RS) are rare anorectal malformations (ARM), comprising 1–2% of all cases. No consensus exists regarding optimal surgical technique. This study evaluated surgical approaches, complications, and long-term functional outcomes at a single referral center.

Methods

Retrospective review of RA or RS patients treated between 2003 and 2020. Surgical technique, complications, and bowel function were analyzed. Fecal continence was assessed using Krickenbeck classification.

Results

Eleven patients were included (7 RS, 4 RA), representing 1.2% of 900 ARM cases. Surgical techniques included posterior sagittal anorectoplasty (PSARP) in 4 (36.4%), transanal in 3 (27.3%), abdominoperineal pull-through in 2 (18.2%), and laparoscopic rectal web correction (LWC) in 2 (18.2%). Two patients required redo surgery. Ten of 11 patients were eligible for functional assessment; no true fecal incontinence was observed. Five (50%) required no bowel management; constipation was identified in five, including three with overflow soiling due to non-adherence. Median follow-up was 100.4 months (range 13–168).

Conclusion

Despite surgical complexity, most patients achieved satisfactory outcomes. The high incidence of constipation, particularly in RS, underscores the need for long-term follow-up and early intervention. The laparoscopic rectal web correction offers a reproducible, sphincter-preserving technique for effective correction of rectal webs.