Re-routing procedures for ectopic anus in the adult

Area of Science:

• Colorectal surgery
• Anorectal physiology
• Surgical reconstruction

Background:

• Ectopic anus, a rare congenital anomaly, can lead to significant fecal incontinence in adults.
• Surgical intervention aims to reposition the anorectum and reconstruct the anal sphincter complex.
• Understanding preoperative sphincter function is crucial for surgical planning.

Observation:

• Four adult patients with ectopic anus and incontinence were evaluated.
• Electromyography (EMG) was used to precisely locate anal sphincters before surgery.
• Surgical technique involved anorectal mobilization and rerouting through the sphincter ring.

Findings:

• Postoperative improvement in anal canal pressures was observed in three patients.
• Successful restoration of fecal continence was achieved in three out of four patients.
• One patient experienced poor outcomes due to persistent, severe constipation.

Implications:

• Surgical repair of ectopic anus can effectively restore fecal continence.
• Pre-existing severe constipation may represent a contraindication for this specific surgical procedure.
• Further research into managing constipation in these patients is warranted.