Skip to main content
Log in

Is posterior anal transfer a good treatment for vestibular anus?

  • Main Topic
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Eleven females who had a posterior anal transfer (PAT) for a vestibular anus were reviewed in order to: (1) assess the long-term functional success of this operation clinically; (2) evaluate the anorectal manometry profile; and (3) assess defaecation by video proctography. The cosmetic appearance was excellent in all patients. Seven had a good result, 2 a fair result, and 2 a poor result when assessed clinically (Kelly score) in terms of constipation and soiling. The anorectal manometry profile remained within normal limits except in the 2 with a poor result who had diminished sensory awareness of stool in the rectum. PAT does not appear to damage the muscle-sphincter complex, and the children with a large rectum full of faeces seemed to behave like children with acquired megacolon and constipation. Video proctography showed normal defaecatory patterns in all patients. Patient selection is important for this procedure. When PAT was used as the initial treatment a good result was obtained; when it was used to relieve constipation following previous surgery the result was less satisfactory.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Browne D (1955) Congenital deformities of the anus and rectum. Arch Dis Child 30: 42–46

    Google Scholar 

  2. Bryndorf J, Madsen C (1959) Ectopic anus in the female. Acta Chir Scand 118: 466–478

    Google Scholar 

  3. De Vries PA, Pena A (1982) Posterior sagittal ano-rectoplasty. J Pediatr Surg 17: 638–643

    CAS  PubMed  Google Scholar 

  4. Iwai N, Yanagihara J, Tokiwa K, Deguchi E, et al. (1988) Results of surgical correction of anorectal malformations. Ann Surg 207: 219–222

    Google Scholar 

  5. Keighley MR, Henry M, Bartolo DC, Mortenson NJ (1989) Anorectal physiology measurement: a report of a working party. Br J Surg 76: 356–357

    Google Scholar 

  6. Kelly J (1972) The clinical and radiological assessment of anal continence in childhood. Aust N Z J Surg 42: 62–63

    Google Scholar 

  7. Matley P, Cywes S, Berg A, Ferreira M (1990) A 20-year follow-up study of children born with vestibular anus. Pediatr Surg Int 5: 37–40

    Google Scholar 

  8. Nixon H, Puri P (1977) Results of treatment of anorectal anomalies. A 13–20 year follow-up. J Pediatr Surg 12: 27–37

    Google Scholar 

  9. Ong N-T, Beasley W (1990) Comparison of clinical methods for the assessment of continence after repair of high anorectal anomalies. Pediatr Surg Int 5: 233–237

    Google Scholar 

  10. Santulli T (1962) Rectum and anus. In: Benson C (ed) Pediatric surgery. Yearbook Medical Publisher, Chicago, pp 829–832

    Google Scholar 

  11. Saxena N, Bhattacharyya C (1981) Perineal anal transplant in low anorectal anomalies. Surgery 90: 464–467

    Google Scholar 

  12. Sun W, Read N, Miner P (1990) Relation between rectal sensation and anal function in normal subjects and patients with faecal incontinence. Gut 31: 1056–1061

    Google Scholar 

  13. Zivkovic S, Krstic Z, Vukanic D (1991) Vestibular fistula: the operative dilemma — cutback, fistula transplantation or PSARP? Pediatr Surg Int 6: 111–113

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Grant, H.W., Moore, S.W., Millar, A.J.W. et al. Is posterior anal transfer a good treatment for vestibular anus?. Pediatr Surg Int 9, 12–16 (1994). https://doi.org/10.1007/BF00176098

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00176098

Key words

Navigation