Long-term functional results after perineal surgery for low anorectal anomalies

Abstract

As part of a long-term follow-up review of anorectal anomalies treated at the Royal Children's Hospital, Melbourne, we examined 70 patients with translevator (low) anomalies treated by a perineal operation and assessed their anorectal function by four clinical scoring methods (Kelly, Templeton, Kiesewetter, and Wingspread). The results were compared qualitatively after conversion into three categories: “good”; “fair”; and “poor”. Over 90% of patients achieved socially acceptable anorectal control. The incidence of accidental defaecation was shown to be age-related, patients seen after 10 years of age having a lower incidence of soiling than younger children. The incidence of smearing or staining did not diminish with age. Prolonged management was required in 5 patients who continued to have a poor level of faecal continence. Anorectal function was not adversely affected by the anterior position of the anal orifice in most patients after simple perineal surgery.