Early Postoperative Outcome of Posterior Sagittal Anorectoplasty for High and Intermediate Variety Anorectal Malformation

Abstract

Background: Posterior sagittal anorectoplasty (PSARP), popularized by de Vries and Peña has become the standard technique for the management of anorectal malformations (ARM). Before 1980, the anatomy of these defects was not known, and the surgical procedure involved several blind steps. In the posterior approach, surgical exposure became available and exposure to the anatomic features of these defects has led to a better understanding of the basic anatomy of ARM. Objectives: To evaluate the early postoperative outcome of posterior sagittal anorectoplasty for high and intermediate variety anorectal malformation. Methods: Quasi experimental study was carried out in the Faculty of Paediatric Surgery, Bangladesh Shishu Hospital and Institute. A total 15 patients were included in this study after fulfillment of all selection criteria during the study period. In this study, 11 (73.3%) patients were intermediate variety and 4(26.7%) patients were high variety anorectal malformation. Results: This study showed that only 1(6.7%) patient had wound infection and wound dehiscence. Total 8 (53.3%) patients had 1-5 bowel movement per day with 07(46.7%) patient had no soiling. 07(46.7%) patients had no constipation and 8(53.4%) patient had constipation. Among the constipation patient, 7(46.7%) were managed by changing diet and 1(6.7%) were managed by laxative. Conclusion: Constipation is the major complication after posterior sagittal anorectoplasty but in experts’ hands, till now, it is a good option for high and intermediate variety anorectal malformation.