Outcome of patients with anorectal malformations after posterior sagittal anorectoplasty

Abstract

Aim and purpose The aim of this study was to evaluate the outcome of patients who underwent posterior sagittal anorectoplasty (PSARP) for the treatment of low or high anorectal malformation (ARM). Patients and methods All patients who underwent standard PSARP were included in this study. Patients with mental retardation were excluded from our study. Patients were classified according to the Rintala score into four categories: poor (6–9); fair (9–11); good (12–17); and normal (18–20). We used a questionnaire introduced by Rintala. The type of anomaly was divided into two categories. We used low and high ARM definitions according to the relationship of the terminal colon to the levator muscles of the pelvic floor. The Student t-test, the Pearson v2-test, one-way analysis of variance, and the Levine test were used for data analysis using SPSS ver. 13.0. Results Sixty patients aged 3–17 years (13.63 ± 3.27 years) were included. The mean of score in patients with low-type ARM was 14.5± 2.6 and that in patients with hightype ARM was 13.19± 3.75 (P = 0.28). The mean of scores was 13.34± 3.5 among male patients and 13.94± 2.9 among female patients. There was no statistically significant difference (P = 0.46). The score was significantly higher in patients with fistula (n= 51, 13.9 ± 3.1) than in patients without fistula (n= 9, 11.8± 3.3; P= 0.03). Excluding two cases with scrotal-type fistula and rectal atresia, there was no significant difference between the two groups (P= 0.06). Conclusion There was no significant difference in the outcome after PSARP between boys and girls. There was no significant difference between low-type and high-type ARM. The mean of score was significantly higher among patients with fistula than among patients without fistula. Keywords : anoplasty, anorectal malformation, constipation, fistula, scrotal, vesical, vestibular