Posterior Sagittal Approach for Nonanorectal Malformation: Widening Spectrum

Area of Science:

• Pediatric Surgery
• Surgical Techniques
• Pelvic Anatomy

Background:

• The posterior sagittal approach is a widely accepted method for treating anorectal malformations.
• It offers excellent perineal access to deep pelvic structures.
• Dissection in the midline minimizes the risk of injury to vital anatomical structures.

Purpose of the Study:

• To evaluate the feasibility of the posterior sagittal approach for indications beyond anorectal malformations.
• To expand the surgical applications of this approach.

Main Methods:

• A retrospective review of 10 pediatric cases operated using the posterior sagittal approach over four years.
• The study included patients with diverse non-anorectal malformations.

Main Results:

• The series included six patients with Disorders of Sexual Differentiation (pseudovagina), three with Y duplication of the urethra, and one with cervical atresia.
• All ten patients achieved favorable surgical outcomes.

Conclusions:

• The posterior sagittal approach is a safe and feasible surgical option for non-anorectal malformations.
• This technique demonstrates minimal bleeding and no postoperative incontinence.
• The spectrum of indications for the posterior sagittal approach can be safely widened.