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Anterior sagittal anorectoplasty as a technique for the repair of female anorectal malformations: A twenty two-years-single-center experience
- Source :
- Journal of Pediatric Surgery. 55:393-396
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Background Anorectal malformations (ARMs) are major congenital malformations occurring in female children in approximately 1 out of every 4000–5000 births. Posterior sagittal anorectoplasty (PSARP) was introduced for their treatment in early 1980s by Pena and Devries. However, anterior sagittal anorectoplasty (ASARP) was first introduced by Okada as a modification of the previous technique. Purpose The aim of this study was to report our experience and the long-term follow-up results of 594 female patients with anorectal malformations treated by anterior sagittal anorectoplasty (ASARP) in a single center over 22 years. We chose this approach as the incision is smaller, with minimal cutting of the external sphincter and easier dissection of the vagina and rectum. The type of our study was retrospective study. Results The study included 594 patients; 342 of them were less than 1 year old. About 526 patients had rectovestibular fistula, anterior perineal anus in 55 patients, anocutaneous fistula in 6 patients and rectovaginal fistula in 7 patients. All of these patients had been subjected to ASARP technique which had been done in one stage without proceeding colostomy in about 470 cases and in staged fashion with a protective colostomy in 124 patients. Postoperative follow up revealed that four patients (0.7%) developed anal retraction, 30 patients (5%) developed anal stricture, 20 patients (3.4%) had rectal prolapse and 40 patients (6.7%) developed anterior anal migration. Constipation was observed in 161 patients (27%) by the end of 1st postoperative year reduced to 41 patients (7%) after one year. 474 patients were assessed for continence by Kelly's continence score and 453 patients showed good result, 16 patients showed fair result and about 5 patients had poor continence outcome. Conclusion Anterior sagittal anorectoplasty is a procedure with optimal functional outcome especially at if done at an early age in one stage without preliminary colostomy.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Fistula
Anal Canal
Rectum
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
030225 pediatrics
Humans
Rectal Fistula
Medicine
Retrospective Studies
business.industry
Rectovaginal Fistula
Colostomy
Infant
General Medicine
Plastic Surgery Procedures
medicine.disease
Anus
Anorectal Malformations
Sagittal plane
Surgery
Rectal prolapse
medicine.anatomical_structure
Rectovaginal fistula
030220 oncology & carcinogenesis
Pediatrics, Perinatology and Child Health
Female
business
Constipation
Anal stricture
Subjects
Details
- ISSN :
- 00223468
- Volume :
- 55
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Surgery
- Accession number :
- edsair.doi.dedup.....97abba4e3cc28f416acec14af6924207