Posterior sagittal anorectoplasty (PSARP)‎ : a new approach for treating anorectal malformations

Abstract EN

Background : -Anorectal malformation is a congenital anomaly of different varieties and its correction needs good experience , knowledge about this varieties and specific surgical tools, otherwise the child may lose his the only chance to live normally without disastrous complication like incontinence.

Objective : -assessment of the advantage of this procedure in management of anorectal malformations and the percentage for anal continence.

Patients and methods : -.

This study was carried out in the child's central teaching hospital in Baghdad total number (70) cases were included in the study, 37 males and 33 females: aged 7 days to 6 years.

They attended the hospital between October 1998-october 2004.

Male defect included : 1) Low type ....

5 cases No colostomy needed.

2) Intermediate type ....

23 cases.

needed colostomy 3) High type ....

9 cases needed colostomy.

• Female defects: 1) Imperforate anus with vestibular fistula---31 cases.

2) Imperforate anus without fistula 2 cases.

Results: From the study we gain the following results : - all the male patients with low and intermediate types 28 cases (40 %) show 100 % continence.

All female patients with imperforated anus with vestibular fistula and without fistula 33 cases (47 %) show 100 % continence.

The combination of male and female patients show 61 patients of 70 show 100 %continence in a percentage of 87 %.

The nine cases (12.

85 %) with recto bladder neck fistula show poor continence due to their bad sacral contour associated with the poor development of pelvic muscles sphincter.

This result was revealed from follow-up together with the presence of external sphincter muscle contraction which occurs during digital PR examination or by the use of surgical dilators.

Conclusion : From the study we found that this procedure gives high percentage of continence and should be used instead of other procedures.