Title: Primary Anterior Saggital Anoplasty in Female Anorectal malformation

Authors: Nitin Goel, Dhiraj Parihar, Preeti Raikwar, Arvinder Pal Singh Batra, Jeewandeep Kaur

 DOI:  http://dx.doi.org/10.18535/jmscr/v3i12.06

Abstract

Aim: To describe the technique and results of anterior saggital approach i.e. Anterior Saggital Anorectoplasty (ASARP) for low & intermediate Anorectal malformation ARM

Methods: Patients with low & intermediate Anorectal malformation (ARM) was taken for ASARP without colostomy as definitive surgery at presentation. Pre-operative preparation was done with rectal washouts and clear liquid diet for 24 hours.  Those patients who require abdominal mobilization does not need to change the position during the procedure in this approach .Rectum is separated from vagina under direct vision and placed in sphincter muscle complex without dividing it .

Results: ASARP was performed on 27 patients, between September 2011 to September 2015 (age range from 3 days to 9 years). Follow up ranges from 3 months to 4 years.3 patients had wound complication in immediate post operative period that was minor wound infection & resolved on conservative management and no patient required colostomy. Four patients presented with anal stenosis which were successfully treated by dilatation. Mucosal prolapse was seen in one patient who was self limiting. Three patients have long term follow up with constipation.

Conclusion: Anterior Saggital approach is technically easy with acceptable complication and showed good cosmetic result in female ARM 

Keywords:  Anorectal malformation, Anterior Saggital Anorectoplasty, Anovestibula

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Corresponding Author

Arvinder Pal Singh Batra

Professor & Head, Anatomy, BPS GMC for Women, Sonepat