{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:21:15Z","timestamp":1787844075679,"version":"build-2784847793"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Anorectal malformations (ARMs) are managed classically in three stages \u2013 colostomy at birth, anorectal pull-through after 2\u20133 months, and stoma closure. Single-stage pull-through has been contemplated in neonatal age aimed to reduce the number of procedures, better long-term continence, the better psycho-social status of the child, and reduced cost of treatment, especially in resource-strained countries. We conducted a systematic review comparing neonatal single-stage pull-through with stage pull-through and did a meta-analysis for the outcome and complications. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. PubMed and Scopus databases were searched and RevMan 5.4.1 was used for the meta-analysis. Fourteen comparative studies including one randomized controlled trial were included in the systematic review for meta-analysis. The meta-analysis included 1845 patients including 866 neonates undergoing single-stage pull-through. There was no statistically significant difference for the occurrence of surgical site infection (odds ratio [OR] 0.82, 95% confidence interval [CI]: 0.24\u20132.83), urinary tract injury (OR 1.82, 95% CI: 0.85\u20133.89), rectal prolapse (OR 0.98, 95% CI: 0.21\u20135.04), anal stenosis\/stricture, voluntary bowel movements (OR 0.97, 95% CI: 0.25\u20133.73), constipation (OR 1.01, 95% CI: 0.61\u20131.67), soiling (OR 0.89, 95% CI: 0.52\u20131.51), mortality (OR 1.19, 95% CI: 0.04\u201339.74), or other complications. However, continence was seen to be better among patients undergoing neonatal pull-through (OR 1.63, 95% CI: 1.12\u20132.38). Thus, we can recommend single-stage pull-through for managing patients with ARMs in the neonatal age.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jiaps.jiaps_28_23","type":"journal-article","created":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T03:02:31Z","timestamp":1693882951000},"page":"357-368","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Can Neonatal Pull-Through Replace Staged Pull-Through for the Management of Anorectal malformation? a Systematic Review and Meta-Analysis"],"prefix":"10.4103","volume":"28","author":[{"given":"Vivek","family":"Manchanda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parveen","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avinash","family":"Jadhav","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akhil Dhanesh","family":"Goel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-1-20240905","doi-asserted-by":"crossref","first-page":"20","DOI":"10.4103\/0189-6725.181702","article-title":"One-stage versus. Three-stage repair in anorectal malformation with rectovestibular fistula","volume":"13","author":"Amanollahi","year":"2016","journal-title":"Afr J Paediatr Surg"},{"key":"R2-1-20240905","doi-asserted-by":"crossref","first-page":"e0170421","DOI":"10.1371\/journal.pone.0170421","article-title":"Laparoscopically assisted anorectal pull-through versus posterior sagittal anorectoplasty for high and intermediate anorectal malformations: A systematic review and meta-analysis","volume":"12","author":"Han","year":"2017","journal-title":"PLoS One"},{"key":"R3-1-20240905","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1097\/01.mop.0000163665.36798.ac","article-title":"Outcomes from the correction of anorectal malformations","volume":"17","author":"Levitt","year":"2005","journal-title":"Curr Opin Pediatr"},{"key":"R4-1-20240905","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1053\/j.sempedsurg.2019.04.016","article-title":"Error traps and culture of safety in anorectal malformations","volume":"28","author":"Bischoff","year":"2019","journal-title":"Semin Pediatr Surg"},{"key":"R5-1-20240905","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1016\/j.jpedsurg.2005.08.002","article-title":"Preliminary report on the international conference for the development of standards for the treatment of anorectal malformations","volume":"40","author":"Holschneider","year":"2005","journal-title":"J Pediatr Surg"},{"key":"R6-1-20240905","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1007\/s10151-015-1267-8","article-title":"European consensus meeting of ARM-Net members concerning diagnosis and early management of newborns with anorectal malformations","volume":"19","author":"van der Steeg","year":"2015","journal-title":"Tech Coloproctol"},{"key":"R7-1-20240905","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"R9-1-20240905","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan-a web and mobile app for systematic reviews","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst Rev"},{"key":"R11-1-20240905","doi-asserted-by":"crossref","first-page":"x","DOI":"10.3310\/hta7270","article-title":"Evaluating non-randomised intervention studies","volume":"7","author":"Deeks","year":"2003","journal-title":"Health Technol Assess"},{"key":"R12-1-20240905","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.jclinepi.2010.04.026","article-title":"GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"R13-1-20240905","doi-asserted-by":"crossref","first-page":"j4008","DOI":"10.1136\/bmj.j4008","article-title":"AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both","volume":"358","author":"Shea","year":"2017","journal-title":"BMJ"},{"key":"R14-1-20240905","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1007\/BF00169662","article-title":"Repair of anorectal anomalies in the neonatal period","volume":"5","author":"Goon","year":"1990","journal-title":"Pediatr Surg Int"},{"key":"R15-1-20240905","first-page":"10","article-title":"Neonatal PSARP versus staged PSARP \u2013 A comparative analysis","volume":"5","author":"Mishra","year":"2000","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"R16-1-20240905","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1053\/jpsu.2000.6925","article-title":"Laparoscopically assisted anorectal pull-through for high imperforate anus \u2013 A new technique","volume":"35","author":"Georgeson","year":"2000","journal-title":"J Pediatr Surg"},{"key":"R17-1-20240905","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1016\/j.jpedsurg.2004.06.021","article-title":"The treatment of high and intermediate anorectal malformations: One stage or three procedures?","volume":"39","author":"Liu","year":"2004","journal-title":"J Pediatr Surg"},{"key":"R18-1-20240905","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1007\/s00383-005-1567-6","article-title":"Management of anorectal malformations in Varanasi, India: A long-term review of single and three stage procedures","volume":"22","author":"Gangopadhyay","year":"2006","journal-title":"Pediatr Surg Int"},{"key":"R19-1-20240905","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/1471-2482-7-20","article-title":"Sphincter saving anorectoplasty (SSARP) for the reconstruction of Anorectal malformations","volume":"7","author":"Pratap","year":"2007","journal-title":"BMC Surg"},{"key":"R20-1-20240905","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1007\/s00383-008-2154-4","article-title":"Single-stage correction of imperforate anus with a rectourethral or a rectovestibula fistula by semi-posterior sagittal anorectoplasty","volume":"24","author":"Zheng","year":"2008","journal-title":"Pediatr Surg Int"},{"key":"R21-1-20240905","doi-asserted-by":"crossref","first-page":"83","DOI":"10.4103\/jiaps.JIAPS_15_17","article-title":"Anorectal malformations in males: Pros and cons of neonatal versus staged reconstruction for high and intermediate varieties","volume":"22","author":"Menon","year":"2017","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"R22-1-20240905","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1007\/s00383-018-4324-3","article-title":"Investigation of the feasibility and safety of single-stage anorectoplasty in neonates with anovestibular fistula","volume":"34","author":"Shirota","year":"2018","journal-title":"Pediatr Surg Int"},{"key":"R23-1-20240905","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1089\/lap.2017.0690","article-title":"One-stage laparoscopic-assisted anorectoplasty for neonates with anorectal malformation and recto-prostatic or recto-bulbar fistula according to the krickenbeck classification","volume":"28","author":"Xiao","year":"2018","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"R24-1-20240905","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1016\/j.jpedsurg.2019.05.020","article-title":"Primary posterior sagittal anorectoplasty outcomes for rectovestibular and perineal fistulas using an accelerated pathway: A single institution study","volume":"54","author":"Rocourt","year":"2019","journal-title":"J Pediatr Surg"},{"key":"R26-1-20240905","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1016\/j.jpedsurg.2021.04.023","article-title":"30-day postoperative outcomes of neonatal versus delayed anoplasty for perineal and vestibular fistulas","volume":"56","author":"Marenco","year":"2021","journal-title":"J Pediatr Surg"},{"key":"R27-1-20240905","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.jpedsurg.2022.01.018","article-title":"One-stage versus staged laparoscopic-assisted anorectoplasty for high-and intermediate anorectal malformations: Medium-term outcomes from a propensity score matching analysis","volume":"57","author":"Zhou","year":"2022","journal-title":"J Pediatr Surg"},{"key":"R28-1-20240905","first-page":"116","article-title":"Primary posterior sagittal anorectoplasty without colostomy in neonates with high imperforate anus","volume":"45","author":"Mirshemirani","year":"2007","journal-title":"Acta Med Iran"},{"key":"R29-1-20240905","doi-asserted-by":"crossref","first-page":"126","DOI":"10.4103\/0971-9261.86863","article-title":"Neonatal posterior sagittal anorectoplasty for a subset of males with high anorectal malformations","volume":"16","author":"Nagdeve","year":"2011","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"R30-1-20240905","doi-asserted-by":"crossref","first-page":"2174","DOI":"10.1016\/j.jpedsurg.2018.02.048","article-title":"Single-stage repair of rectoperineal and rectovestibular fistulae can be safely delayed beyond the neonatal period","volume":"53","author":"Short","year":"2018","journal-title":"J Pediatr Surg"},{"key":"R31-1-20240905","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1186\/s12887-021-02761-6","article-title":"Accuracy of pre-operative fistula diagnostics in anorectal malformations","volume":"21","author":"Tofft","year":"2021","journal-title":"BMC Pediatr"},{"key":"R32-1-20240905","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/j.jpedsurg.2005.12.021","article-title":"Colostomy in anorectal malformations: A procedure with serious but preventable complications","volume":"41","author":"Pena","year":"2006","journal-title":"J Pediatr Surg"},{"key":"R33-1-20240905","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1016\/j.jpedsurg.2017.03.050","article-title":"The high pressure distal colostogram in anorectal malformations: Technique and pitfalls","volume":"52","author":"Abdalla","year":"2017","journal-title":"J Pediatr Surg"},{"key":"R34-1-20240905","doi-asserted-by":"crossref","first-page":"3472","DOI":"10.1007\/s00330-015-3786-0","article-title":"High resolution MRI for preoperative work-up of neonates with an anorectal malformation: A direct comparison with distal pressure colostography\/fistulography","volume":"25","author":"Thomeer","year":"2015","journal-title":"Eur Radiol"},{"key":"R35-1-20240905","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/s00247-018-04339-4","article-title":"Comparison of diagnostic accuracy for fistulae at ultrasound and voiding cystourethrogram in neonates with anorectal malformation","volume":"49","author":"Hosokawa","year":"2019","journal-title":"Pediatr Radiol"},{"key":"R36-1-20240905","doi-asserted-by":"crossref","first-page":"5156","DOI":"10.1007\/s00464-016-4841-x","article-title":"Congenital anomaly rectified at birth: One-stage single-incision laparoscopic-assisted anorectoplasty for newborns with anorectal malformations and recto-urethral fistula","volume":"30","author":"Diao","year":"2016","journal-title":"Surg Endosc"},{"key":"R37-1-20240905","first-page":"701","article-title":"Transperineal intracath meconiolysis and evacuation technique of \u201cdistended\u201d bowel evacuation for one-stage laparoscopic anorectoplasty for high anorectal malformations in males","volume":"30","author":"Agrawal","year":"2020","journal-title":"J Lap Adv Surg Tech"},{"key":"R38-1-20240905","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1016\/j.jpedsurg.2014.01.051","article-title":"Anorectal malformations with good prognosis: Variables affecting the functional outcome","volume":"49","author":"Arnoldi","year":"2014","journal-title":"J Pediatr Surg"},{"key":"R39-1-20240905","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.1016\/j.jpedsurg.2007.07.014","article-title":"Primary laparoscopic repair of high imperforate anus in neonatal males","volume":"42","author":"Vick","year":"2007","journal-title":"J Pediatr Surg"},{"key":"R40-1-20240905","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1016\/j.jpedsurg.2016.06.001","article-title":"Anorectal malformation with rectobladder neck fistula: A distinct and challenging malformation","volume":"51","author":"Samuk","year":"2016","journal-title":"J Pediatr Surg"},{"key":"R41-1-20240905","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1016\/j.jpedsurg.2015.05.004","article-title":"Unexpected megarectum: A potential hidden source of complications in patients with anorectal malformation","volume":"50","author":"De la Torre-Mondrag\u00f3n","year":"2015","journal-title":"J Pediatr Surg"}],"container-title":["Journal of Indian Association of Pediatric Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_28_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:04:13Z","timestamp":1787843053000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_28_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":38,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/jiaps.jiaps_28_23","relation":{},"ISSN":["0971-9261"],"issn-type":[{"value":"0971-9261","type":"print"}],"subject":[],"published":{"date-parts":[[2023,9]]}}}