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Published on: October 25, 2024
Transanoproctoplasty: a 21-year review
Basem A Khalil1, Antonino Morabito, Adrian Bianchi
1Department of Paediatric Surgery, Royal Manchester Children's Hospital, M27 4HA Manchester, UK.
Journal of Pediatric Surgery
|September 21, 2010
Summary
Transanal anorectoplasty is a safe surgical option for imperforate anus, offering good long-term continence rates. Patient outcomes depend on pelvic floor anatomy and neurology.
Area of Science:
- Pediatric Surgery
- Colorectal Surgery
- Congenital Abnormalities
Background:
- Transanal anorectoplasty (TAR) developed as an alternative to posterior sagittal anorectoplasty (PSARP) for imperforate anus management.
- This study evaluates the surgical approach and long-term outcomes of TAR.
Purpose of the Study:
- To assess the safety and efficacy of transanal anorectoplasty.
- To evaluate the long-term functional outcomes, particularly continence, following TAR for imperforate anus.
Main Methods:
- Retrospective review of 245 patients treated between 1984 and 2005.
- Data collected included operative details, complications, and long-term outcomes.
- Patients were analyzed based on pelvic floor status, fistula location, and sacral ratio.
Main Results:
- 245 patients underwent TAR; 85% had a well-formed perineum.
- Continence was achieved in 182 of 212 evaluated patients (85.8%).
- Complications were low, with 2.5% experiencing wound infection or breakdown.
Conclusions:
- Transanal anorectoplasty is a safe procedure with low morbidity for imperforate anus.
- It allows accurate rectal placement within the sphincter complex, preserving continence.
- Outcomes are linked to the patient's initial pelvic floor anatomy and neurology.