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Does fecal continence improve with time after posterior sagittal anorectoplasty for high type imperforate anus?

Author: Ahmed Zubar Zain
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2016 Volume: 15 Issue: 2 Pages: 30-33
Publisher: Al-Mustansyriah University الجامعة المستنصرية


Background: anorectal malformation represent a spectrum of defects, which may be benign, non complex with a good functional prognosis, to more severe malformations involving the genitourinary system with poor prognosis for bowel and urinary function. Aim: to assess fecal continence after posterior sagittal anorectoplasty (PSARP) with its relation to the post-operative time and to describe the complications of PSARP. Patients and method: this prospective study was conducted in the pediatric surgery department of Al-Kadhymia teaching hospital. The duration of the study was five years from 1st January 2009 to the 31st December 2013.Kelly's methods was applied for assessing the grade of continence after 6 months, one year, and two years after closure of colostomy. Also we describe the complications of PSARP after closure colostomy. PSARP was performed according to Pena method & the results were evaluated after colostomy closure. Results: forty patients with high type imperforate anus were included in this study. They were 25 males (62.5%) and 15 females (37.5%). Genitourinary anomalies were the commonest associated anomalies. There was no accidental defecation in 12 cases (30%) after six months, and 15cases (37.5%) after two years, while there was constant defecation in 4 patients (10%) after 6 months , in 3 patients(7.5%) after 1 year, and in two patients (5%) after two years. Wound infection was the commonest complication and occurred in 8 patients (20%), followed by rectal prolapse in 7 patients (17.5%). Conclusion:Initial poor results should not discourage the surgeon as the condition of the patient and grade of the continence keeps improving as child grows.

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