The Anterior Sagittal Anorectoplasty Technique (ASARP) for Treatment of Female Anorectal Malformations: Our Experience | [Pakistan Paediatric Journal • 2017]

Author(s):

1. MUHAMMAD AFZAL: Department of Pediatric Surgery, The children’s Hospital & the Institute of Child Health, Lahore, Pakistan

2. NABILA TALAT: Department of Pediatric Surgery, The children’s Hospital & the Institute of Child Health, Lahore. Pakistan

3. ARSALAN RAZA WASTI: Department of Pediatric Surgery, The children’s Hospital & the Institute of Child Health, Lahore. Pakistan

4. Sarfraz Ahmed: Department of Pediatric Surgery, The children’s Hospital & the Institute of Child Health, Lahore. Pakistan

5. Muhammad Bilal Mirza: Department of Pediatric Surgery, The children’s Hospital & the Institute of Child Health, Lahore. Pakistan

6. Muhammad Saleem: Department of Pediatric Surgery, The children’s Hospital & the Institute of Child Health, Lahore. Pakistan

Abstract:

Objective: To evaluate the outcome of ASARP technique for the treatment of female anorectal malformations in terms of functional outcome and complications. Place and Duration of Study: Department of Pediatric Surgery, The Children’s Hospital and Institute of Child Health Lahore from March, 2011- Feb, 2013. Patients and Methods: This study is a prospective and descriptive study. Female patients with congenital anorectal malformations who underwent anorectoplasty through anterior sagittal approach were included in the study. Surgery was done either as primary or staged procedure (with initial colostomy). The recordings for demographic data and presenting complaints were done on a prescribed proforma. Follow-up was done in OPD. Results: Thirty-eight patients with mean age of 2.5 years underwent anorectoplasty through anterior sagittal approach. Thirty patients had ASARP as a primary procedure. Staged procedure with initial colostomy was done in 8 patients. During surgery, vaginal tear occurred in 4, while partial tear of most distal part of rectal fistula occurred in 2 patients. At follow-up 3 patients had oval shaped anus rather than rounded one resulting in less than satisfactory cosmetic results. Minimal surgical site infection occurred in 5 patients while severe infection resulting in total disruption and requiring redo surgery was seen in 2 patients. There were 2 cases of anal stenosis and 3 cases of rectal mucosal prolapse. Constipation with fecal impaction occurred in 6 cases. One patient had anal retraction. Conclusion: The anterior sagittal anorectoplasty procedure performed in The Children's Hospital & The Institute of Child Health, had complications comparable to previous international studies, so anorectoplasty can satisfactorily be done through anterior sagittal approach in females with anorectal malformations. Primary ASARP has almost the same results as staged procedure. Therefore, to avoid extra procedure of colostomy primary ASARP should be opted.

Page(s): 153-157

DOI: DOI not available

Published: Journal: Pakistan Paediatric Journal, Volume: 41, Issue: 3, Year: 2017

Keywords:

Vestibular fistula , Anterior sagittal anorectoplasty , perineal ectopic anus , Anorectal Malformations

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