Single-stage treatment of rectal atresia by transanal approach: No need for stoma

Rectal atresia is an extremely rare condition among anorectal anomalies. Rectal atresia and associated congenital anomalies have been reported previously; however, rectal atresia with left renal agenesis and hypospadias has not been previously reported in the English literature. We report the successful treatment of rectal atresia in a neonate with left renal agenesis and hypospadias using a single-stage endoanal approach without stoma. A one-day-old male neonate was transferred to our department because a firm tube could not be passed into the rectum. On inspection of the perineum, the anal opening was normal, and the external genitalia showed hypospadias with hooded prepuce. During the operation, a cross-shaped incision was made in the most proximal mucosa of the anal canal, which ended blindly above the dentate line, and the rectal canal was reached by dissection. The proximal rectal mucosa and distal dentate line mucosa were anastomosed. Thus, type II rectal atresia was repaired primarily and successfully without stoma using a single-stage transanal approach. Follow-up was uneventful for four years. Transanal anorectal anastomosis without stoma offers a safe, effective, and comfortable technique for the treatment of rectal atresia and decreases the risk of injury.

Keywords: Anorectal anomalies, newborn, rectal atresia, rectal stenosis, surgery.