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Continence after posterior sagittal anorectoplasty.

R A Langemeijer1, J C Molenaar

  • 1Department of Pediatric Surgery, Sophia Children's Hospital, Erasmus University Medical School, Rotterdam, The Netherlands.

Journal of Pediatric Surgery
|May 1, 1991
PubMed
Summary

Posterior sagittal anorectoplasty (PSARP) for high anorectal malformations yields good aesthetic results but does not restore normal continence. Most patients experience significant incontinence post-surgery.

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Area of Science:

  • Pediatric Surgery
  • Colorectal Surgery
  • Developmental Biology

Background:

  • Posterior sagittal anorectoplasty (PSARP) is a surgical technique for high anorectal malformations.
  • Previous reports suggested high rates of postoperative continence after PSARP.

Purpose of the Study:

  • To evaluate the long-term functional outcomes, specifically continence, following PSARP for high anorectal malformations.
  • To assess PSARP in light of new understandings of anorectal embryology and pelvic floor anatomy.

Main Methods:

  • A cohort of 50 patients with high anorectal malformations underwent PSARP.
  • Postoperative evaluation included subjective assessment (anamnesis) and objective measures (electrostimulation, defecography, anorectal manometry).

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Main Results:

  • Subjectively, most patients reported daily soiling and incontinence.
  • Objectively, nearly all patients demonstrated incontinence, with only one showing near-normal defecation function.
  • While aesthetically satisfactory, PSARP did not achieve normal continence in the studied cohort.

Conclusions:

  • PSARP, despite its aesthetic benefits, does not lead to normal continence in patients with high anorectal malformations.
  • Current understanding of anorectal development suggests limitations in achieving optimal continence with PSARP.