Role of sagittal anorectoplasty in treating constipation in patients with recto-perineal fistula

Role of sagittal anorectoplasty in treating constipation in patients with recto-perineal fistula

Background Recto-perineal fistula is a common anorectal anomaly, affecting both males and females. The anus is abnormally anteriorly located and is usually stenotic. Management of recto-perineal fistula is a dialectic problem. The most common presenting complaint is constipation; also, long-term fol...

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Bibliographic Details
Published in:Annals of pediatric surgery Vol. 16; no. 1; pp. 7 - 5
Main Authors: Bayoumi, Moustafa Mohamed Mahmoud, Allam, Ayman Mostafa, AbouZeid, Amr Abdelhamid
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 22-01-2020
Springer Nature B.V
SpringerOpen
Subjects:
Anorectal malformation
Anorectoplasty
Anus
Classification
Constipation
Feces
Females
Fistula
Laxatives
Medicine
Medicine & Public Health
Original Research
Ostomy
Patients
Pediatrics
Postoperative period
Recto-perineal fistula
Surgery
Surgical techniques
Sutures
Vagina
Wound dehiscence
Recto-perineal fistula
Anorectoplasty
Constipation
Anorectal malformation
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Summary:Background Recto-perineal fistula is a common anorectal anomaly, affecting both males and females. The anus is abnormally anteriorly located and is usually stenotic. Management of recto-perineal fistula is a dialectic problem. The most common presenting complaint is constipation; also, long-term follow-up of these patients revealed high incidence of postoperative constipation. Results The study included 30 patients (19 female and 11 male). Their age at time of repair ranged from 3 to 78 months. We compared the pre- and postoperative constipation rate after limited posterior sagittal anorectoplasty (PSARP) using Krickenbeck score. Overall, the rate of constipation has dropped from 77 (23/30) to 30% (9/30) after surgery. Fourteen patients out of 23 patients with preoperative constipation were cured. Another patient with preoperative constipation improved regarding the grade of constipation. The remaining 8 patients with preoperative constipation did not show improvement after operation. These results were statistically significant (McNemar test). Out of the 9 patients who were still constipated after surgery, 7 had associated fecal soiling that showed good response with bowel management of constipation. Conclusion Limited posterior sagittal anorectoplasty can have a role in treating constipation among cases of recto-perineal fistula.
ISSN:2090-5394
1687-4137
2090-5394
DOI:10.1186/s43159-019-0016-6