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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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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Abstract	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.
AbstractList	BackgroundRecto-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.ResultsThe 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.ConclusionLimited posterior sagittal anorectoplasty can have a role in treating constipation among cases of 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 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. Abstract 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.
ArticleNumber	7
Author	Bayoumi, Moustafa Mohamed Mahmoud AbouZeid, Amr Abdelhamid Allam, Ayman Mostafa
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Cites_doi	10.1016/j.jpedsurg.2008.10.092 10.1016/j.jpedsurg.2010.02.042 10.1007/s00383-006-1789-2 10.1186/1750-1172-2-33 10.1016/S0022-3468(98)90431-6 10.1007/s00247-014-2897-0 10.1016/S0011-3840(02)70014-2 10.1097/01.XPS.0000508435.98985.a2 10.1007/s00383-010-2697-z 10.1016/S0022-3468(82)80448-X 10.1016/S0022-3468(97)90628-X 10.1016/0022-3468(92)90562-L 10.1016/S0002-9610(00)00491-8 10.1016/j.jpedsurg.2008.03.047 10.1097/01.XPS.0000484840.40461.85 10.1016/j.jpedsurg.2005.08.002 10.1097/01.XPS.0000469264.36689.34 10.1016/S0022-3468(78)80315-7 10.1007/s00384-014-2074-9 10.1007/978-3-319-14989-9_8
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Keywords	Recto-perineal fistula Anorectoplasty Constipation Anorectal malformation
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Cheu
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Snippet	Background Recto-perineal fistula is a common anorectal anomaly, affecting both males and females. The anus is abnormally anteriorly located and is usually... BackgroundRecto-perineal fistula is a common anorectal anomaly, affecting both males and females. The anus is abnormally anteriorly located and is usually... Abstract Background Recto-perineal fistula is a common anorectal anomaly, affecting both males and females. The anus is abnormally anteriorly located and is...
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SubjectTerms	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
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Title	Role of sagittal anorectoplasty in treating constipation in patients with recto-perineal fistula
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