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Abstract:Introduction: One in 5,000 live births is found to have anorectal malformations with a female preponderance. These patients are managed during the first year of their life with advanced health care facilities. Still a few cases present in adult life. Case Report: One such case of a 24 year old female is reported here who presented with chronic constipation. Transverse colostomy was done at birth, soon after diagnosing anorectal malformation. The stoma underwent spontaneous closure and she continued to pass faeces through anovestibular fistula. Anterior sagittal anorectoplasty was performed and a continent neo-anus was created. Conclusion: Careful neonatal examination shall diagnose all anorectal malformations at birth. Illiteracy, lack of neonatal health care, inadequate medical facilities are some of the reasons for the delayed diagnosis and persistence of this condition till adulthood. Most pediatric surgeons consider posterior sagittal anorectoplasty as the procedure of choice in treating anorectal malformation.

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Background: Stapled haemorrhoidopexy is a non-excisional approach for haemorrhoids as opposed to conventional open Milligan-Morgan and Ferguson closed haemorrhoidectomy techniques. It repositions the prolapsed haemorrhoid tissue and also causes vascular interruption to the haemorrhoids. This causes faster recovery and lesser post-operative pain.Methods: In authors institute, stapled haemorrhoidopexy was being carried out using two rows proximate PPH circular haemorrhoidal stapler. In February 2018, MIRUS three rows circular stapler was introduced. This is a retrospective observational study carried out at Artemis Hospital, Gurgaon, India. Authors studied records and operative notes of all patients who underwent stapled haemorrhoidopexy between February 2018 and September 2019 and compared key parameters.Results: A total of 224 patients underwent stapled haemorrhoidopexy between February 2018 and September 2019. 116 using MIRUS three rows circular stapler and 108 using two rows proximate PPH circular haemorrhoidal stapler. Most of the studied parameters were comparable with only significant statistical difference seen in higher use of haemostatic sutures in two rows stapler group compared to three rows stapler group. Haemostatic sutures were needed in three row stapler group for 27 patients and in two rows stapler group for 39 patients.Conclusions: Author’s initial experience shows slightly better haemostasis with three rows stapled haemorrhoidopexy with no significant difference in other parameters.

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