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

Annals of Pediatric Surgery - Tập 16 Số 1 - 2020
Moustafa Mohamed Mahmoud Bayoumi1, Ayman M. Allam2, Amr Abdelhamid AbouZeid3
1Department of Pediatric Surgery, Faculty of Medicine, Ain Shams University, 3 Elhashmy Street, Cairo, 13752, Egypt
2Department of Pediatric Surgery, Ain Shams University, 12 Elhomossany Street, Kobri Elkoba, Cairo, 11766, Egypt
3Department of Pediatric Surgery, Ain Shams University, Lotefy El-Sayed Street, 9 Ain-Shams University buildings, Abbassia, Cairo, 11657, Egypt

Tóm tắt

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.

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Annals of Pediatric Surgery

Tập 16 Số 1

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