Anterior versus posterior sagittal anorectoplasty without colostomy for repair of vestibular anus

ABSTRACT

In this study, rectovestibular and anovestibular fistulae were repaired in 30 girls using the sagittal anorectoplasty technique without colostomy over a period of three years. A preoperative preparation of the bowels was performed using low residue diet, oral mannitol 10% as laxative, intestinal antiseptics and broad spectrum antibiotics with a gradual restoration of oral feeding after surgery. The anterior approach was adopted in 15 consecutive patients and their results were compared with those of other 15 ones to whom the posterior approach was performed. The incidence of wound infection was slightly higher in the PSARP group than in the ASARP, but in both groups, it was mild with no complete disruption of the wound. Generally, excellent results with normal bowel function were obtained in 19 cases with nearly equal results in both ASARP and PSARP groups. Good results having mild constipation that responded to diet or simple laxative with occasional soiling occurred in eight cases. Fair outcome was more frequent in PSART group. Complete incontinence with a poor outcome was not encountered in any of the two groups