Ano-rectal malformations

ABSTRACT

OBJECTIVE: To assess the type of anorectal anomalies among the patients presenting to us and to compare our results with other published series. DESIGN: Retrospective study. PERIOD July 1995 to December 2001. SETTING: Department of Paediatric Surgery, Allied Hospital, Faisalabad. PATIENTS AND METHODS: All patients presenting to the Department of Paediatric Surgery, Allied Hospital, Faisalabad for management of anorectal anomalies were included in the study. The patients presented either for the initial management, for the definitive procedure, colostomy closure or management of complications. A total of 365 patients were managed during the study period. Of these 265 patients presented for the initial management. The majority [60.37%] came within 72 hours. MF ratio was 1.85 1. High and intermediate anomalies constituted 56.1%. Initially Colostomy was done in 160 cases and Anoplasty/ Cut Back in 93. Of the 160 patients in whom an initial colostomy was performed to date only 43 have had the definitive procedure done. Posterior Sagittal Anorectoplasty [PSARP] was done in 30 cases and Anterior Sagittal Anorectoplasty [ASARP] in 11 cases. Colostomy closure was done in 27 patients. Among postoperative complications wound infection was the commonest. Continence rate on follow up is within the acceptable range. Recorded mortality was low but we noted a significant percentage of hidden' mortality. Colostomy performed in patients with anorectal malformations is a major cause of the 'hidden' mortality associated with the management of this condition. Proper care of the colostomy needs to be achieved to reduce this