Abstract
To compare the results of the staged procedure (Group A) with the primary single stage posterior sagittal anorectoplasty (PSARP) procedure (Group B) for high and intermediate anorectal anomalies. Four hundred ninety cases of primary single stage procedure done over a period of seven years (1996–2003) were compared with 458 out of 763 cases of staged procedure (Historical control) that underwent all three stages done from 1989 to 1996. Two hundred cases that had been in regular follow up in Group A and 254 cases in Group B who had attained three years of age were evaluated for continence by Kelly’s method. The approximate cost of treatment was also calculated. Continence was good in 90 cases (45%), fair in 66 cases (33%) and poor in 44 cases (22%) in Group A while it was good in 204 cases (80% ), fair in 38 cases (15%) and poor in 12 cases (5%) in Group B. In Group A, the mortality was high as only 40% cases completed all the three stages of operation. The mortality was 4.5% in Group B. Primary PSARP is recommended as the better treatment option for intermediate and high-anorectal anomalies with superior results in terms of morbidity, mortality, continence and cost.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
De Vries P, Pena A (1982) Posterior sagittal anorectoplasty. J Pediatr Surg 17:638–643
Kelly JH (1969) The radiographic anatomy of the normal and abnormal neonatal pelvis. J Pediatr Surg 4:432
Kelly JH (1969) Cine radiography in anorectal malformations. J Pediatr Surg 4:538
Rintala RJ, Lindahl HG (1999) Posterior sagittal anorectoplasty is superior to sacroperineal-sacroabdominoperineal pull-through: a long-term follow-up study in boys with high anorectal anomalies. J Pediatr Surg 34:334–337
Gil-Vernet JM, Asensio M, Marhuenda C, Broto J, Wayar A (2001) Nineteen years experience with posterior sagittal anorectoplasty as a treatment of anorectal malformation. Cir Pediatr 14:108–111
Bliss DP Jr, Tapper D, Anderson JM et al (1996) Does posterior sagittal anorectoplasty in patients with high imperforate anus provide superior fecal continence? J Pediatr Surg 31:26–30
Mulder W, de Jong E, Wauters I, Kinders M, Heij HA, Vos A (1995) Posterior sagittal anorectoplasty: functional results of primary and secondary operations in comparison to the pull-through method in anorectal malformations. Eur J Pediatr Surg 5:170–173
Rintala RJ, Lindahl H (1995) Is normal bowel function possible after repair of intermediate and high anorectal malformations? J Pediatr Surg 30:491–494
Langemeijer RA, Molenaar JC (1991) Continence after posterior sagittal anorectoplasty. J Pediatr Surg 26:587–590
Albanese C, Jennings RW, Lopoo JB et al (1999) One stage correction of high imperforate anus in the male neonate. J Pediatr Surg 34:834–836
Dobbing J, Sands J (1973) Quantitative development of growth and development of the human brain. Arch Dis Child 48:757
Moore TC (1990) Advantages of performing the sagittal anoplasty operation imperforate anus at birth. J Pediatr Surg 25:276
Mishra BN, Narasimhan KL, Chowdhary SK, Samujh R, Rao KLN (2000) Neonatal PSARP versus staged PSARP: a comparative analysis. J Indian Assoc Ped Surg 5:10–13
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gangopadhyay, A., Gopal, S.C., Sharma, S. et al. Management of anorectal malformations in Varanasi, India: a long-term review of single and three stage procedures. Ped Surgery Int 22, 169–172 (2006). https://doi.org/10.1007/s00383-005-1567-6
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-005-1567-6