Anoplasty for low anorectal malformation.

Area of Science:

• Pediatric Surgery
• Colorectal Surgery
• Congenital Malformations

Background:

• A slightly anterior, stenotic anus is a low anorectal malformation, often presenting as a rectoperineal fistula.
• Key symptoms include constipation and straining, with potential diagnostic challenges in newborns.
• Hendren anoplasty, a simple surgical technique, was described in 1978 for this condition.

Purpose of the Study:

• To evaluate the efficacy and outcomes of Hendren anoplasty for low anorectal malformations.
• To clarify the clinical presentation and management of this specific type of anorectal malformation.

Main Methods:

• Retrospective review of clinical data for patients who underwent Hendren anoplasty between 2009 and 2015.
• Follow-up data collected via office visits and telephone interviews with families and primary care physicians.

Main Results:

• Seven patients (4 boys) with intractable constipation underwent Hendren anoplasty for an anteriorly located stenotic anal orifice.
• The condition was not recognized at birth in 4 out of 7 cases; anoplasty was performed at a median age of 8 months.
• At a median follow-up of 32 months, 4 patients required no or minimal laxatives, and 2 had good symptom control with daily laxatives.

Conclusions:

• Low anorectal malformation/rectoperineal fistula can be easily overlooked in newborns.
• Symptomatic cases can be successfully treated with a simple anoplasty, yielding excellent long-term results.