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Updated: Jun 16, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Perineal body-sparing transsphincteric anorectoplasty (TSARP) for rectovestibular fistula: Mid-term functional
Berat Dilek Demirel1, Başak Dağdemir Ezber2, Beytullah Yağız2
1Department of Pediatric Surgery, Ondokuz Mayıs University, Samsun, Turkey. bdayhan@hotmail.com.
Purpose:
This study aimed to evaluate the mid-term functional and cosmetic outcomes of perineal body-sparing trans-sphincteric anorectoplasty (TSARP) in patients with anal atresia and rectovestibular fistula.
Methods:
Patients with anal atresia and rectovestibular fistula who underwent perineal body-sparing TSARP between 2018 and 2024 were retrospectively reviewed. All procedures were performed by a single pediatric surgeon. Demographic data, presence of colostomy, perioperative complications, postoperative first-feeding time, and functional outcomes were recorded. Functional outcomes in patients were assessed using the Krickenbeck classification.
Results:
Twenty-six patients underwent perineal body-sparing TSARP. One-stage repair was performed in 16 patients (61.5%), whereas 10 (38.5%) had a protective colostomy. The median age at operation was 40 days (range 2 days-7 months). Posterior vaginal wall injury occurred in two patients and was repaired uneventfully. Two patients developed wound infection that resolved with local wound care. The mean follow-up duration was 3.25 years. Among 18 patients older than 3 years old, voluntary bowel control was present in 15 patients (83.3%). Constipation occurred in seven patients, and no patient developed soiling.
Conclusion:
Perineal body-sparing TSARP appears to be a safe and effective technique for rectovestibular fistula, providing low complication rates with satisfactory functional and cosmetic outcomes.
