Anterior saggital anorectoplasty; the treatment of anorectal malformations in female children

ABSTRACT

Anorectal malformation is the common congenital malformation. Ectopic anus and vestibular fistula are Intermediate types of anorectal malformations [ARM], which are the most common in female babies. Many surgical procedures have been described for the treatment of ARM. Anterior Saggital Anorectoplasty [ASARP] is not only convenient for the anesthetist for maintenance of anesthesia but also gives better exposure of surgical structures during surgery. To determine the technical suitability and outcome of ASARP in intermediate types of ARM in female children. This Descriptive study with prospective collection of data according to a set protocol. The study was carried out at the department of Pediatric Surgery, Military Hospital, Rawalpindi, Pakistan. November 2010 to March 2014, over the period of 3 years and 5 months. The data of all female patients presenting with intermediate types of ARM and undergoing ASARP, during the study period were analyzed, with respect to age, type, associated anomalies, complications and cosmetic outcome. A total of 36 patients of intermediate variety underwent ASARP. Age ranged from 6 months to 22 years. All patients had colostomy prior to this procedure. During surgery, posterior vaginal wall tear occurred in 2 patients [5.5%]. Postoperatively, 2 patients [5.5%] had retention of urine, 2 patients [5.5%] developed wound infection with superficial disruption, anal stenosis occurred in 2 patients [5.5%] and 1 patient [2.7%] had rectal mucosa prolapse. None of them required re_ do surgery. Cosmetic outcome was excellent in 31 patients [86.1%], while it was satisfactory in 5 [13.8%] patients. Anorectoplasty through anterior approach is not only technically easy but has good cosmetic results in intermediate type of imperforate anus in female children