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One stage operation through modified posterior sagittal approach for imperforate anus (Abstract)

Nguyen Thanh Liem,

Department of Surgery, National Hospital of Pediatrics

Hanoi, Vietnam

 

Abstract

Purpose: To describe the surgical technique and preliminary results of a one stage operation through modified posterior sagittal approach (PSAP) for anorectal malformations.

Material and Methods: 66 patients were operated by a one-stage operation through a modified PSAP from January 1998 to November 2005. The operation was performed in one-stage through a posterior sagittal approach with three modifications: The external sphincter complex was not opened on the posterior side, the dissection was carried out outside the rectal pouch and the rectal pouch was not tapered.

Results: There were 57 girls and 9 boys, ranging from 2 days to 12 months of age. The types of anorectal malformations included anal atresia with vestibular fistula in 53 patients, anal atresia with urethral fistula in 7 patients, anal atresia without fistula in 4 patients and anorectal atresia with vaginal fistula in 2 patients. The mean operative time was 68 minutes. There was one death on the fifth postoperative day due to bronchopneumonia and associated heart anomaly. Rectal retraction occurred in two patients and required a second operation. All of the remaining patients could pass stool spontaneously before discharge.

Conclusion: One stage operation through modified PSAP is feasible and safe for anorectal malformations.

Key words: anorectal malformation, modified PSAP, one-stage operation

 

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