Pj. Javid et al., IMMEDIATE AND LONG-TERM RESULTS OF SURGICAL-MANAGEMENT OF LOW IMPERFORATE ANUS IN GIRLS, Journal of pediatric surgery, 33(2), 1998, pp. 198-202
Background: The majority of girls with imperforate anus are reported t
o have a malformation of the low variety. Despite this, much of the li
terature has focused on the more complex, high lesions. Methods: This
study reviews our experience with 44 girls with low imperforate anus f
rom a 22-year period. Results: The incidence of associated anomalies w
as 61%, which is higher than generally reported. All patients in the s
tudy had anal fistulae. Fifty-seven percent had perineal fistulae, 23%
had fourchette fistulae, and 20% had vestibular fistulae. Cutback ano
plasty was performed in 55%, Potts transfer anoplasty was used in 27%,
and 18% of patients were treated with either limited posterior sagitt
al anorectoplasty or anterior sagittal anorectoplasty. Surgical compli
cations were uncommon. Long-term follow-up was carried out by telephon
e survey. This showed 89% of the girls to be successfully toilet train
ed. However, 47% of patients experience at least occasional soilage or
episodic fecal incontinence. Conclusions: Low imperforate anus can be
successfully treated using a variety of procedures without colostomy.
Most girls with low imperforate anus are successfully toilet trained,
but problems with continence persist in a significant number of these
patients. Copyright (C) 1998 by W.B. Saunders Company.