Related Experiment Videos
Ectopic anus in childhood
A Ottolenghi1, M Sulpasso, S Bianchi
1Department of Surgery, Verona University, Italy.
Insights
This study presents non-invasive and posterior anal transplant treatments for ectopic anus, showing good results in improving fecal continence and aesthetics. These methods offer effective alternatives to complex surgical techniques.
Area of Science:
- Pediatric Surgery
- Colorectal Surgery
- Anorectal Malformations
Background:
- Ectopic anus, particularly perineal and vulvar types, can be associated with constipation due to external sphincter dysfunction.
- Previous surgical techniques for these conditions exist, but novel approaches are explored.
- Fecal continence issues can arise from reduced anorectal angulation in some cases.
Purpose of the Study:
- To evaluate the efficacy of non-invasive treatment for symptomatic primary perineal anus.
- To assess the outcomes of posterior anal transplant via the perineum in infants and children with vulvar anus.
- To investigate the role of the perineal spur in fecal continence.
Main Methods:
- Non-invasive treatment was applied to patients with primary perineal anus.
- Posterior anal transplant was performed in six pediatric patients with vulvar anus.
- Outcomes were assessed based on esthetic improvement and fecal continence.
Main Results:
- Non-invasive treatment showed positive effects on symptomatic primary perineal anus.
- Posterior anal transplant yielded good esthetic and functional results within three months.
- Improved fecal continence was observed, potentially linked to enhanced anorectal angulation and perineal spur function.
Conclusions:
- Non-invasive and posterior anal transplant are effective treatments for certain types of ectopic anus.
- Posterior anal transplant offers a less complex alternative with good outcomes.
- The perineal spur appears to be a crucial component in maintaining fecal continence.
Abstract:
The treatment of ten cases of ectopic anus is presented in this paper. The association of constipation with perineal anus due to alignment disturbance of the external sphincter triple loop system during evacuation has been described by Hendren (1978), Leape and Ramenofsky (1978), Upadhyaya (1984) et al. Hendren, Leape and Ramenofsky described two valid surgical techniques for this association. In this paper we describe the effect of non-invasive treatment in patients affected by symptomatic "primary" perineal anus. We also describe the effect of posterior anal transplant via the perineum in six infants and children with vulvar anus. This approach gave good results within three months without having to perform more complex operative techniques (Peña for example). Posterior anal transplant leads not only to an esthetic improvement but also to an improvement in fecal continence, which is sometimes deficient due to reduced anorectal angulation. It appears to us that an adequate perineal spur plays an important complementary role in the complex mechanism which controls fecal continence.