Primary anorectoplasty in females with common anorectal malformations without colostomy

Menon, Prema; Rao, K. L. N.

doi:10.1016/j.jpedsurg.2007.01.056

Cited by 70 publications

(52 citation statements)

References 12 publications

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“…In the recent literature, more surgeons tend to do a single-stage procedure for ARM with vestibular fistula. In a prospective study of 72 ARM patients with VF who underwent PSARP without colostomy, all patients had good or fair fecal continence; in only 5 (6.9 %), mild infection was observed [17]. Kumar carried out a retrospective trial of 123 low type ARM patients who underwent single-stage PSARP or ASARP.…”

Section: Discussionmentioning

confidence: 99%

The management of anorectal malformation with congenital vestibular fistula: a single-stage modified anterior sagittal anorectoplasty

Wang

Liu

et al. 2015

Pediatr Surg Int

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Section: Discussionmentioning

confidence: 99%

The management of anorectal malformation with congenital vestibular fistula: a single-stage modified anterior sagittal anorectoplasty

Wang

Liu

et al. 2015

Pediatr Surg Int

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“…Better exposure and precise placement of the anal canal within the external sphincter complex have made the posterior and anterior sagittal approaches more popular and established for the correction of AVF. Pena [5] recommended a posterior sagittal approach for this anomaly and later on this approach has also been used by others [6][7][8]. Anterior sagittal approach that utilizes the same basic principles as that of the posterior one was first reported by Okada [9] and later on by Wakhlu [10] and Aziz [11].…”

Section: Introductionmentioning

confidence: 99%

“…Repair under cover of a colostomy is considered the safest option for these cases [12,13]. On the other hand, reports of one stage correction of vestibular anus are also available [7][8][9][10][11]14]. Even amongst those who recommend a one stage repair, the opinion differs in whether an early postoperative feed should be given or not.…”

Section: Introductionmentioning

confidence: 99%

“…Okada [9] and Sanchez [6] have recommended that prolonged fasting for 2 weeks is necessary for the proper healing of the wound. Others [7,8,10,11,14] feel an absolute fasting is not necessary for these cases. Herewith, we are presenting our experience of operating AVF by anterior sagittal anorectoplasty (ASARP) through different regimes available.…”

Section: Introductionmentioning

confidence: 99%

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Anterior sagittal anorectoplasty for anovestibular fistula

Kulshrestha

Sarkar

et al. 2007

Pediatr Surg Int

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Anterior sagittal anorectoplasty (ASARP) was used for the definitive correction in 107 cases of anovestibular fistula (AVF) between 1996 and 2005. These cases were subjected to three different types of treatment regimes during the same period. Majority of the cases (78) were operated in one stage where postoperatively an early oral feed was started (A). Cases were discharged in 2-4 days. In the second group (B), there were ten cases who were also operated in one stage but with prolonged fasting of 9-10 days postoperatively. Nineteen cases (C) were operated under cover of colostomy during the same period. In the immediate postoperative period, among the group A, one case had a major wound disruption requiring a colostomy and a redo surgery. Three cases had subcutaneous leak. In seven cases there was premature dehiscence of mucocutaneous or skin sutures. In groups B and C, there were no significant complications in the immediate postoperative period. In the follow-up period, out of 107 cases, 63 (58.8%) had constipation at the end of 3 months. However, at the end of one year, only 24.3% (26 cases) cases had constipation. Regarding fecal continence, 86 cases (90.5%) were totally continent. Seven had history of occasional soiling and in two cases, soiling was more frequent. As far as repair or correction of AVF or vestibular anus is concerned, we feel that anterior sagittal approach is more suitable as it requires less pelvic dissection. Separation of posterior vaginal wall from rectum, which is considered, is the most important step of the operation, takes place under direct vision. We also feel that AVF can be repaired in one stage with an early postoperative oral feed, provided we are meticulous in pre and postoperative bowel management. It reduces hospital stay and the cost of treatment. This provides a good option to cases who are not able to afford prolonged hospitalization (fasting) or are not willing for a colostomy.

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“…Similar practice with excellent results was observed by Menon and Rao from Chandigarh, India, in the management of vestibular fistula by primary posterior sagittal anorectoplasty. (19) In the anterior approach (ASARP), the incision is much smaller and requires the division of only anterior fibers of external sphincter complex, while posteriorly it remains intact. Thus the amount of tissue dissection in posterior approach is more, therefore a larger area would be at risk in case if infection occurs.…”

Section: Discussionmentioning

confidence: 99%

Anorectal Malformation Female Children One Stage Procedure Asarp

Shrivastava¹

2016

jemds

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CONTEXTAnorectal malformation is a common congenital defect in children and its management has evolved over the years. Anterior sagittal approach is established as a popular technique for the correction of anovestibular fistula in children with anorectal malformations due to advancement of technology magnification, muscle stimulation and precise placement of the anal canal within the external sphincter complex. AIMSTo study the outcome of anterior sagittal approach as single stage procedure for anorectal malformations in female children at tertiary care centre. SETTINGS AND DESIGNPaediatric Surgery Department, Gandhi Medical College, Bhopal. A retrospective analysis. METHODS24 female patients with congenital anorectal malformation who underwent Anterior Sagittal Anorectoplasty (ASARP) as a single stage procedure were reviewed. The surgical procedure and its outcome were evaluated. RESULTSThere was no case that had significant haemorrhage during or after procedure; 4 cases had rent in the posterior vaginal wall which was managed adequately due to early detection. There were six cases with wound infection. One case had dehiscence; three cases developed constipation, which was managed with dilation and bowel training. CONCLUSIONASARP as a single stage procedure without colostomy cover should be considered as a preferable option for the management of anovestibular fistula in female children.

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Primary anorectoplasty in females with common anorectal malformations without colostomy

Cited by 70 publications

References 12 publications

The management of anorectal malformation with congenital vestibular fistula: a single-stage modified anterior sagittal anorectoplasty

The management of anorectal malformation with congenital vestibular fistula: a single-stage modified anterior sagittal anorectoplasty

Anterior sagittal anorectoplasty for anovestibular fistula

Anorectal Malformation Female Children One Stage Procedure Asarp

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