Management of anorectal malformation: Changing trend over two decades in Zaria, Nigeria

Management of anorectal malformation: Changing trend over two decades in Zaria, Nigeria

Anorectal malformation is a common congenital defect and its management has evolved over the years. This is a review of the trend in the management of this condition in a major paediatric surgical centre in Nigeria over two decades. A retrospective analysis of 295 patients with anorectal malformatio...

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Bibliographic Details
Published in:African journal of paediatric surgery Vol. 8; no. 1; pp. 19 - 22
Main Authors: Lukong, C S, Ameh, E A, Mshelbwala, P M, Jabo, B A, Gomna, A, Akiniyi, O T, Nmadu, P T
Format: Journal Article
Language:English
Published: India Medknow Publications and Media Pvt. Ltd 01-01-2011
Medknow Publications & Media Pvt. Ltd
Wolters Kluwer Medknow Publications
Subjects:
Abnormalities
Anal Canal - abnormalities
Anal Canal - surgery
Anorectal disorders
Anorectal malformation
Anus
Care and treatment
Child
Child, Preschool
Children & youth
Colostomy
Colostomy - mortality
Colostomy - trends
Diagnosis
evaluation
Female
Health aspects
Hospitals, Teaching
Humans
Infant
Infant, Newborn
Male
management
Mortality
Nigeria
Nigeria - epidemiology
outcome
Patient outcomes
Reconstructive Surgical Procedures - mortality
Reconstructive Surgical Procedures - trends
Rectum - abnormalities
Rectum - surgery
Retrospective Studies
Surgery
Survival Analysis
Teaching hospitals
Treatment Outcome
Trends
Nigeria
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Summary:Anorectal malformation is a common congenital defect and its management has evolved over the years. This is a review of the trend in the management of this condition in a major paediatric surgical centre in Nigeria over two decades. A retrospective analysis of 295 patients with anorectal malformations managed from January 1988 to December 2007 was carried out. There were 188 boys and 107 girls aged 1 day-9 years (median 8 years) at presentation. There were 73 (54.5%) and 106 (65.8%) emergency operations in groups A and B, respectively. There were 61 (45.5%) and 55 (34.2%) elective operations in groups A and B, respectively. Regarding treatment, in group A, patients requiring colostomy had transverse loop colostomy, while in group B, sigmoid (usually divided) colostomy was preferred. The definitive surgery done during the two periods were: group A: cutback anoplasty 29 (47.5%), anal transplant 5 (8.2%), sacroabdominoperineal pull through (Stephen's operation) 6 (9.5%) and others 21 (34.4%). In group B, posterior sagittal anorectoplasty (PSARP) 46 (83.7%), anal transplant 1 (1.8%), posterior sagittal anorectovaginourethroplasty (PSARVUP) 2 (3.6%) and anal dilatation 6 (10.9%) were done. Early colostomy-related complication rates were similar in the two groups (P > 0.05). The overall late complication rate was 65.5% in group A and 16.4% in group B (P < 0.05). The mortality was 25 (18.6%) in group A compared to 17 (10.6%) in group B (P < 0.05). There have been significant changes in the management of anorectal malformations in this centre in the last two decades, resulting in improved outcomes.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ISSN:0189-6725
0974-5998
DOI:10.4103/0189-6725.78663