ABSTRACT
Objective: the usual reported incidence of Imperforate anus 1 per 5000 live births. There is slight predominance in males. The incidence of these anomalies is not affected by the parity of the mother, the mother's age, or the race or nationality of the child's family. Imperforate anus is classified into high, intermediate, and low according to the level at which arrest of rectal descent occurred. The surgical management of low imperforate anus in females continues to develop. Two common surgical procedures are applied. Cutback anoplasty and Potts transfer anoplasty. Although surgery for girls with low imperforate anus has been considered to have good results, several reports suggest problems with continence
Aim of the work: the purpose of the study was to characterize the nature of anorectal malformation and to evaluate end results of different surgical procedures, then recording immediate and long term outcomes .
Methods: This study was done on 23 girls with low imperforate anus operated upon by cutback anoplasty and Potts transfer anoplasty in Sohag university hospital, department of surgery from May 1995 to May 2000.
Results: All patients had low anomalies and anal fistulae. Ten patients (43.5%) had anovestibular fistula, 8 (34.8%) had anoperineal fistula and 5 (21.7%) had anovulvar fistula. Cutback anoplasty was performed in 10 patients, 8 had anoperineal fistula and 2 had anovulvar fistula.
Potts transfer anoplasty was performed in 15 patients (10 had anovestibular fistula, 3 had anovulvar fistula and 2 patients had persistent anovulvar fistula after failure of Cutback anoplasty). Early post operative complications included wound infection in 10) patients and wound dehiscence in 6. Late complications included anal stenosis in 6 patients, constipation in 18 and recurrent fistula in 2 cases.
Conclusion:
Low imperforate anus in girls can be successfully treated by using surgical procedures without colostomy. Potts transfer anoplasty (anal transposition) is easy to perform, perfect, safe and has less postoperative complications. It has good long term anal function and accepted rate of continence.