Clinical and radiological postoperative evaluation of posterior sagittal anorectoplasty in patients with upper and intermediate anorectal malformations
Keywords:
Anorectal malformations, Posterior sagittal anorectoplastyAbstract
The PSARP is today the most-used surgical technique for correction of high and intermediary anorectal malformations.There is much controversy in the literature about the post-operative evaluation of these cases. We studied 27 cases of anorectal malformations from clinical and radiological aspects, in order to analyse: 1. Fecal continence 2.Relationship between post-operative fecal continence and the associated sacral anomalies 3.Relationship between the radiological evaluation by defecogram and fecal continence From the analysis of the cases, we concluded: 1. Fecal continence was achieved in 48.14% of the cases; partial continence in 25.92%; and fecal incontinence in 25.92% of the cases. 2.The presence of fecal incontinence was directly related to the associated sacral anomalies.
Downloads
References
Peña A , DeVries SPA- Posterior sagital anorectoplasty: important technical considerations and applications. J Pediatr Surg 1982; 17(6):796-811.
Haberkorn S, Mathias A L ,Teixeira M G, et al. - Defecograma: técnica simplificada e dados de interpretação. Rev Ass Med Bras 1978; 24(10):361-2.
Martins J L - Avaliação pós-operatória de crianças portadoras de anomalias anorretais submetidas a correção cirúrgica pela anorretoplastia sagital posterior. Tese de Docência Livre. Escola Paulista de Medicina. lllp, 1993.
Siegel S - Estadistica parametrica. Ed.Trillas.Mexico. 346p, 1975.
Partridge J P & Gough M H - Congenital abnormalities of the anus and rectum. Brit J Surg 1961; 49:37-50.
Swenson 0 & Donnellan W L - Preservation of the puborectalis sling in imperforate anus repair. Surg Clin North Amer 1967; 47:173-93.
Stephens F D & Smith E D - Anorectal malformations in children. Year Book Medical Publishers. Chicago, 1971.
Templeton Jr J M & Diteshein J A - High imperforate anus: quantitative results of long term fecal continence. J Pediatr Surg 1985; 20(6):645-52.
Langemeijeir R A T M& Mollenaar J C - Continence after posterior sagital anorectoplasty. J Pediatr Surg 1991; 26(5):587-590.
Peña A - Posterior sagital approach for correction of anorectal malformations. Adv Surg 1986; 19:69-100.
Martins J L - Complicações no tratamento das anomalias anorretais.In:Margarido N F,Saad R, Cecconello I, Martins J L & Soares L A - Complicações em Cirurgia. 1ª Ed. São Paulo: Ed.Robe,1992:297-313.
Kelly J H - Cineradiography in anorectal malformations. J Pediatr Surg 1969; 4(5):538-46.
Kelly J H -The clinical and radiological assesment of anal continence in childhood. Aust N Z J Surg 1972; 42(1):62-63.
Cywes S, Cremin B J & Louw J H - Assesment of continence after treatment for anorectal agenesis: a clinical and radiologic correlation. J Pediatr Surg 1972; 6:132-137.