Long-term continence in patients with high and intermediate anorectal anomalies treated by sacroperineal (Stephens) rectoplasty

Thirty-seven patients treated at the Royal Children's Hospital, Melbourne, by Stephens (sacroperineal or sacroabdominoperineal) rectoplasty were reviewed after 5 to 32 years. Continence was assessed using the Kelly, Templeton, Kiesewetter, and Wingspread criteria. Although approximately 20% of the patients were shown to have unsatisfactory control with each clinical scoring system, the remainder have a socially acceptable level of fecal control. Several patient groups had more favorable results than others: (1) females; (2) patients who did not have an abdominal component to their rectoplasty; and (3) patients reviewed more than 10 years after surgery. Twenty-eight patients reached their final level of continence in the first few years and nine improved gradually throughout childhood.