Single Stage Reconstructive Surgery to Treat Anorectal Malformations in Neonates; Ten Years Experience
Keywords:Anorectal malformations, Posterior Sagittal Anorectoplasty, Rectoperineal Fistula, Recto-vaginal fistula, Recto-vestibular fistula, Recto-urinary fistula
Objective: To present single surgeonâ€™s ten yearsâ€™ experience of Single stage reconstructive surgery in 26 neonates born with anorectal malformations (ARMs) and review of literature.
Methodology: This is a retrospective study of 26 neonates admitted in NICU with diagnosis of ARMs between period of June 2011 to Oct 2021 and managed by single stage reconstructive surgery with an average follow up of three years. All these patients were full term. The diagnosis was confirmed on clinical examination supported by cross table lateral film in prone position after 24 hours and ultrasound evaluation of level of rectal pouch. Single stage reconstructive surgery was done under general anesthesia within 24 to 48 hours after birth. The outcome of single stage reconstruction of neonates with anorectal malformations is evaluated post operatively during an average regular follow up of 3 years.
Results: All the 26 neonates are treated by single stage reconstructive surgery between 24 to 48 hours after birth during the period from June 2011 to Oct 2021 who were admitted with anorectal malformations in NICU after excluding associated congenital anomalies. Â All the patients had excellent cosmetic and functional outcome without significant problem of wound infection. Only 3 female patients with recto-vestibular fistula had mild superficial wound infection and were managed conservatively.
Conclusion: Single stage reconstructive surgery to treat ARMs in neonates I effective, safe and feasible with good continence. It avoids morbidity and higher cost associated with three stage surgeries and colostomy. This fact may further be confirmed through multi-institutional experience in large number of patients.
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