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19–22 APRIL, 2017, BARCELONA, SPAIN
RESULTS
The tumour diameter was 4 cm. The operative time was 180 mnutes, tumor extirpation time was
33 minutes. There was no complication after surgery, blood loss 150 mL, negative tumor margins,
and post op hospitalization was 4 days. The serum creatinin, glomerular filtration rate, and hemo-
globin level were nearly unaltered before and after surgery.
CONCLUSIONS
Thulium laser demonstrated acceptable hemostasis and precise resection capability of the renal
cortex during open partial nephrectomy without ischaemia. Our case showed promising periop-
erative and postoperative outcomes including minimal blood loss, zero ischaemia, negative tumor
margins, short length of hospitalization, and preservation of renal function.
VS-34 (VS without presentation)
POSTERIOR AND ANTERIOR SAGITTAL ANORECTOPLASTY
APPROACHES: APPLICATIONS OF TWO TECHNIQUES
IN RECTOURETHRAL AND RECTOGENITAL ANOMALIES
IN CHILDREN
M S ANSARI
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Urology and renal transplantation, Lucknow,
INDIA
PURPOSE
Many procedures have been described in the past to deal various rectourethral and rectogenital
anomalies. Most of them had limitations like incomplete exposure, blind tunnelling of rectum, lack
of anatomical reconstruction of perineal body with more anterior migration of the anus. Both pos-
terior [PSRP] and anterior sagittal anorectoplasty [ASARP] provide better exposure of the muscle
complex, rectal wall, direct vision of fistulous opening, good exposure of operative field, adequate
mobilization of rectum and anatomical reconstruction of perineal body. Both the techniques have
their advantages and disadvantages.
Here in the authors present their experience with Posterior [PSARP] and anterior sagittal anorecto-
plasty [ASARP] in various genitourinary anomalies.
MATERIAL AND METHODS
Records of pediatric patients who underwent PSARP and ASARP for rectourethral fistulae [RUF]
both acquired and congenital were reviewed. Besides RUF other associated conditions were, pos-
terior urethral stricture, posterior urethral diverticulum, duplication of urethra and rectovestibular
fistula. The results were reviewed in terms of feasibility and outcome of the two techniques in these
conditions.
RESULTS
Between January 2008 to June 2015, 10 patients with a median age of 5.8 yrs. underwent PSARP
[n=6] and ASARP [n=4]. The indications were isolated RUF [7], RUF with posterior urethral stricture
[1], RUF with posterior urethral diverticulum [1], duplication of urethra and rectovestibular fistula
[1]. Two patients had recurrence of RUF in PSARP group who were successfully managed with
ASARP approach. None had urinary or faecal incontinence.
CONCLUSIONS
Both PSARP and ASARP give direct access to RUF sparing the external urinary sphincter area.
ASARP provides additional advantage of dealing with associated posterior urethral abnormalities
like stricture urethra, diverticulum, and duplication of urethra and rectovestibular fistula avoiding
trans-sphicteric approach.