Modified proctoperineoplasty in anorectal malformation in children

Abstract

Surgical management of anorectal malformations remains a very pressing issue. Stone-Benson, Rizzoli, Penа surgeries and their modifications have been used lately. However, along with undisputed advantages, the surgeries have some shortcomings resulting in a high percentage of unsatisfactory results. Purpose : to improve the results of anorectal malformation management by introducing a new modified correction method of perineal and vestibular fistula in children. Materials and methods : the article is based on the analysis results of 116 children from 1998 to 2018. According to the International Crackenback Classification, the children were diagnosed with perineal and vestibular fistulas. 38 of them underwent proctoperineoplasty modified by the clinic (patent for invention IAP 04799). Results : Stone-Benson proctoperineoplasty resulted in complications in 18.9% of children, whereas proctoplasty modified by the clinics was followed by complications in 9.5% of children. 22.8% of children had remote complications following Stone-Benson proctoperineoplasty, 12.3% of children developed the same when the modified version was used. Conclusion : owing to the modification, an adequately functioning rectal closing apparatus was created, anal incontinence was prevented and normal view of the perineum was restored. This resulted in social adaptation and improved the children’s quality of life.