OUTCOME OF POSTERIOR SAGITTAL ANORECTOPLASTY IN ANORECTAL MALFORMATIONS WITH AND WITHOUT FISTULA IN TERTIARY CARE CENTRES OF NORTH INDIA

Abstract

Introduction: Anorectal malformations (ARM) have been a source of concern for centuries. The reported incidence of ARM is 1 in every 2500 to 5000 live births but maybe even more frequent in certain 1,2 developing countries . Although ARM comprise approximately 0.2-0.3% births. They have been reported to comprise up to 3,4,6-24 1.2% of reported birth defects. Approximately 36.4% are isolated lesions and 63.6% are associated with other anomalies . ⁵ Studies demonstrated several mutations of HLXB9 associated with ARM . 33 patients with intermediate 25 Method and Material: ARM were included A thorough perineal examination, complete haemogram, urine analysis, colposcopy and . radiological studies were conducted. Patients underwent PSARP, the comparison of late complications and functional outcome at the end of 1 year follow- up in ARM patients with and without stula was done. Fischer Exact Test was done for getting Two tailed P- value. Observation and Results: Out of 33 patients 16 males were without stula and 17 males were with rectourethral stula. 33 patients underwent PSARP, 8 cases (24.24%) had early complications. Late complications in 12 cases (36.36%). No postoperative complications were recorded in 13 (39.39%) children. At end of follow-up, 31 remaining patients (including patients with supercial wound infection) had normal looking perineal body and anus with good contraction. No recurrence of stula, stenosis of anus or anterior displacement of rectum. PSARP is a useful procedure for the correction Conclusion: of ARM in children in developing countries and quality of life depends on clinical status of patient and age at the time of presentation. No signicant statistical differences in quality of life was seen in patients with stula vs patients without stula post PSARP