PERINEAL CANAL

Perineal canal (PC) is a rare anomaly constituting 4% of all anorectal malformations. Sixty patients (56 females and 4 males) with PC manage d over the past 27 years are reported. The ages ranged from 2 days to 13 years. The chief symptom was passage of fecal matter through both t he anus and the fistula. One girl had undergone previous, unsuccessful surgery. All our patients were treated by anterior sagittal anorectop lasty (ASARP), which allowed anatomic exposure and accurate repair of the anomaly. In 49 patients without any perineal inflammation primary ASARP was undertaken. Surgery was delayed in 11 patients with perineal excoriations and/or active inflammation. One patient died post-operat ively due to unrelated causes and 1 developed a recurrence. Anal dilat ion was required in 7 cases. Fifty patients were seen at first follow- up 12 weeks after surgery. All were continent and had normal defecatio n without the use of laxatives. Thirty-four could be followed up to th e age of 3 years; they were continent with normal bowel habits. There was no shift in the position of the anus and no instance of rectal dil ation. Individualization of the management and operation by the anteri or sagittal approach thus offers good results in this uncommon anorect al anomaly.