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Post PSRRP anorectol manometry--experience of 115 cases of imperforate anus

A K Ray1, A K Singhania, S Mukherjee

  • 1Department of Paediatric Surgery, Medical College, Kolkata 700073.

Journal of the Indian Medical Association
|January 8, 2005
PubMed

Insights

This study evaluated anorectal continence in 115 infants after post-sagittal anorectoplasty (PSARP) for anorectal malformations. Results indicate that most patients with intermediate anomalies achieve continence, assessed clinically and via manometry.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Developmental Biology

Background:

  • Anorectal malformations (ARMs) require surgical correction, typically involving a proximal pelvic colostomy followed by post-sagittal anorectoplasty (PSARP).
  • The goal of PSARP is to establish fecal continence through a surgically created neo-anus.
  • Conventional treatment involves colostomy closure after neo-anal dilatation, aiming for continence by 9 months of age.

Purpose of the Study:

  • To evaluate anorectal continence in infants following PSARP for high and intermediate anorectal malformations.
  • To correlate clinical assessment (Kiesewetter criteria) with anorectal manometry findings in assessing continence.
  • To analyze the outcomes in a cohort of patients treated between 1993 and 1999.

Main Methods:

  • Retrospective analysis of 115 infants who underwent PSARP and subsequent colostomy closure.
  • Anorectal manometry was performed to assess anal sphincter function and rectal sensitivity.
  • Clinical continence was evaluated using the Kiesewetter criteria.

Main Results:

  • The study included 115 patients, with 103 having intermediate and 12 having high anorectal anomalies.
  • Both clinical evaluation and anorectal manometry were used to assess continence outcomes.
  • Detailed results on continence rates based on anomaly type and assessment method were analyzed.

Conclusions:

  • PSARP is a key surgical procedure for anorectal malformations, aiming for fecal continence.
  • Anorectal manometry provides objective data to complement clinical assessments of continence.
  • The study provides insights into the long-term functional outcomes of PSARP in pediatric patients.

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