ABSTRACT
Introduction: The number of patientswith various types of Anorectal malformations(AMR) are constantly increasing by ourdata. We estimate an average 10 incidenceof ARM per year and it is as twice increasedas compared to 5 patients in 1996-2000.Thepurpose of this study was to determine anincidence, types of ARM and evaluate theresults of PSARP procedure using Kelly’sscoring system.Materials and methods: A total 124patients were retrospectively reviewed andanalyzed.There were 38 patients with ARMwithout fistula, 86 patients with fistula, withprevalence of perineal fistula, 2 cloacas, 6with rectal stenosis, 7 with ectopic anus and2 with acquired atresia due to postoperativesevere anal stenosis.Results: 63 patients underwent colostomyprocedure during neonatal age, 31 patientsunderwent primary operations, 73 patientsunderwent PSARP procedure as a secondaryoperation between 4 months to 1 year ofage and 6 patients underwent redo PSARPprocedure at 8-10 years of age.One patientwith 2 cm of common channel of cloacaunderwent total urogenital mobilization at 2years of age.In 9 patients PSARP procedurewas combined with laparoscopy (LAARPprocedure with ligation of bladderneck andprostatic fistula), in 4 with laparotomy. 6patients underwent buginage of perinealfistula followed by primary PSARPprocedure.Another 6 patients underwentPSARP procedure and closure of colostomyat the same time.In 21 patients we observed6 types of complications such as severeanal stenosis acquired atresia, mislocatedanus, constipation, soiling, and recurrenceof rectouretral fistula and mortality duringneonatal age.Conclusion: The favorable results ofPSARP procedure were achieved in 71.4% ofpatients using Kelly’s clinical scoring system.Usage of Laparoscopy during abdominalstage is favorable, while it allows closureof colostomy at the same time. There is apotential for increasing of primary PSARPprocedure as though there is a prevalence oflow type malformations with perineal fistula.