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The posterior sagittal trans-sphincteric and trans-rectal approaches
1Division of Pediatric Surgery, Schneider Children's Hospital, 269-01 76th Avenue, New Hyde Park, NY 11040, USA. psarp@lij.edu
Techniques in Coloproctology
|May 17, 2003
Summary
The posterior sagittal trans-sphincteric approach is a valuable surgical option for pelvic conditions, offering good outcomes for bowel and urinary control. It is particularly useful for complex cases like Hirschsprung
Area of Science:
- Surgical techniques
- Pelvic reconstructive surgery
- Colorectal surgery
Background:
- The posterior sagittal trans-sphincteric approach has historical roots but has not achieved widespread popularity.
- Evaluating its benefits and drawbacks is crucial for surgical practice.
Purpose of the Study:
- To assess the advantages and disadvantages of the posterior sagittal trans-sphincteric approach.
- To provide a historical and experiential evaluation of the technique.
Main Methods:
- A comprehensive literature review from 1877 to the present.
- Retrospective analysis of authors' surgical experience with 114 patients.
- Evaluation focused on treatment outcomes, complications, and functional control.
Main Results:
- The posterior sagittal trans-sphincteric approach (85 patients) and transanorectal approach (29 patients) were analyzed.
- Postoperative bowel and urinary control were generally preserved, barring pre-existing conditions.
- Complications included fistula recurrence and wound dehiscence.
Conclusions:
- The posterior sagittal trans-sphincteric approach is a viable alternative for specific pelvic conditions.
- It is particularly beneficial for complications of Hirschsprung's disease and acquired fistulae.
- The transanorectal variant offers excellent surgical exposure without compromising functional control.