Complications of posterior sagittal anorectoplasty

Nakayama, Donald K.; Templeton, John Y.; Ziegler, Moritz M.; O’Neill, James A.; Walker, Adrian B

doi:10.1016/s0022-3468(86)80218-4

Cited by 24 publications

(19 citation statements)

References 5 publications

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“…Holschneider [12] reported 15.5% anal stenosis, 5% mucosal prolapse, and 7% relapse of anorectal or anovaginal fistula with 16.6% overall lethality in his series [12]. Other complications like temporary femoral nerve palsies, multiple rectocutaneous fistula, and posterior diverticulum comparable to a large anal crypt were also reported [13]. Sawicka [14] reported sacral bone defect in 10% of patients in his series of patients who underwent 1-stage repair with result of fecal continence defined as normal in 93% and good in 7% of cases.…”

Section: Discussionmentioning

confidence: 97%

Single-stage repair of vestibular and perineal fistulae without colostomy

Kumar

Kandpal

Sharma

et al. 2008

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 97%

Single-stage repair of vestibular and perineal fistulae without colostomy

Kumar

Kandpal

Sharma

et al. 2008

Journal of Pediatric Surgery

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“…The most frequent functional disorder encountered after treatment for imperforate anus in which the rectum has been preserved is constipation [26][27][28].…”

Section: • Functional Disorders ‫ؠ‬ Constipationmentioning

confidence: 99%

Vitellointestinal (omphalomesenteric) duct anomalies

2006

Operative Pediatric Surgery 6Ed

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Anorectal malformations comprise a wide spectrum of diseases, which can affect boys and girls, and involve the distal anus and rectum as well as the urinary and genital tracts. They occur in approximately 1 in 5000 live births. Defects range from the very minor and easily treated with an excellent functional prognosis, to those that are complex, difficult to manage, are often associated with other anomalies, and have a poor functional prognosis. The surgical approach to repairing these defects changed dramatically in 1980 with the introduction of the posterior sagittal approach, which allowed surgeons to view the anatomy of these defects clearly, to repair them under direct vision, and to learn about the complex anatomic arrangement of the junction of rectum and genitourinary tract. Better imaging techniques, and a better knowledge of the anatomy and physiology of the pelvic structures at birth have refined diagnosis and initial management, and the analysis of large series of patients allows better prediction of associated anomalies and functional prognosis. The main concerns for the surgeon in correcting these anomalies are bowel control, urinary control, and sexual function. With early diagnosis, management of associated anomalies and efficient meticulous surgical repair, patients have the best chance for a good functional outcome. Fecal and urinary incontinence can occur even with an excellent anatomic repair, due mainly to associated problems such as a poorly developed sacrum, deficient nerve supply, and spinal cord anomalies. For these patients, an effective bowel management program, including enema and dietary restrictions has been devised to improve their quality of life. DefinitionAnorectal malformations comprise a wide spectrum of diseases, which can affect boys and girls, and involve the distal anus and rectum as well as the urinary and genital tracts. Defects range from the very minor and easily treated with an excellent functional prognosis, to those that are complex, difficult to manage, are often associated with other anomalies, and have a poor functional prognosis.

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“…Nonetheless, many patients may continue to present functional problems following surgery, reflected through varying degrees of fecal escape and constipation. [41][42][43][44][45] CONCLUSIONS Computerized anorectal manometry and profilometry are very useful methods for physiologically evaluating the anorectal region of children who have undergone surgery to correct anorectal anomalies. They are also very useful for postoperative follow-up and therapeutic planning, with objective and efficacious criteria.…”

Section: Resultsmentioning

confidence: 99%

Posterior sagittal anorectoplasty in anorectal anomalies: clinical, manometric and profilometric evaluation

2007

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CONTEXT AND OBJECTIVE: Anorectal malformations comprise a spectrum of anomalies that continue to be difficult to treat, even today. The aim was to evaluate the fecal continence of children who underwent posterior sagittal anorectoplasty due to anorectal malformations, via computerized anorectal manometry and profilometry. DESIGN AND SETTING:Prospective study at Universidade Federal de São Paulo.METHOD: 82 patients (56.1% boys; 43.9% girls) of mean age 85.5 months were evaluated. They were divided into continent, partially continent and incontinent groups. Age, sex, manometric variables and profilometric parameters were studied. The results were statistically analyzed. RESULTS:Among the 82 patients, 37.8% were continent, 25.6% were partially continent and 36.6% were incontinent. The overall mean resting pressure was 22 mmHg, and the means for the continent, partially continent and incontinent groups were, respectively, 30.7 mmHg, 23 mmHg and 14.7 mmHg. The overall mean pressure response to voluntary contraction was 56 mmHg, and the means for the groups were 65.4 mmHg, 55.8 mmHg and 46.6 mmHg, respectively. The rectosphincteric reflex was absent in 82.9% of the cases. In the profilometry analysis for all patients together, blue (20 to 50 mmHg) and yellow (50 to 80 mmHg) were predominant, and there was a similar distribution for the continent and partially continent patients. However, among the incontinent patients, green (< 20 mmHg) and blue prevailed.CONCLUSIONS: Manometric and computerized profilometric analyses were an excellent method for postoperative evaluations on patients with intermediate and high anorectal anomalies, and for therapeutic planning.

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Complications of posterior sagittal anorectoplasty

Cited by 24 publications

References 5 publications

Single-stage repair of vestibular and perineal fistulae without colostomy

Single-stage repair of vestibular and perineal fistulae without colostomy

Vitellointestinal (omphalomesenteric) duct anomalies

Posterior sagittal anorectoplasty in anorectal anomalies: clinical, manometric and profilometric evaluation

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