Transanal end-to-end rectoanal pullthrough for treatment of rectal atresia: A review of 4 cases

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Abstract Introduction: Rectal atresia is a rare subtype of anorectal malformations in which the patients are born with a normal anal canal but have complete atresia located few centimeters proximal to the dentate line. We present the transanal end-to-end rectoanal anastomosis as a surgical technique for the management of these patients, highlight the outcomes, and emphasize on some clinical tips. Methods: Four patients were diagnosed as having rectal atresia on clinical and radiological basis. All of them underwent single loop low sigmoid colostomy in the first 24 hours. After 6 months, transanal end-to-end rectoanal anastomosis was performed followed by closure of the stoma 3 months later. Results: The 2 cases that are older than 3 years demonstrated normal continence and are clean between bowel movements, while the other two showed good anal tone and passing stools between 1–3 times daily, being dry in between. Conclusion: Transanal end-to-end rectoanal anastomosis allows a safer route of anatomical reconstruction of the anorectum, therefore avoiding the potential complications associated with the other more invasive approaches.

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