Posterior sagittal anorectoplasty: Primary repair of a rectovaginal fistula in an adult

Paquette, Edmond L.; Tapper, David; Holland, Randall

doi:10.1007/bf02050938

Cited by 16 publications

(7 citation statements)

References 8 publications

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“…Although the total number of patients in the literature who underwent primary repair is not many, most authors have reported good results, some of them anecdotal in adults with rectovaginal fistula [10,11]. In the largest study reported so far, 47 patients with rectovestibular fistula underwent fistula transposition without colostomy [12].…”

Section: Discussionmentioning

confidence: 99%

Primary anorectoplasty in females with common anorectal malformations without colostomy

Menon

Rao

2007

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Primary anorectoplasty in females with common anorectal malformations without colostomy

Menon

Rao

2007

Journal of Pediatric Surgery

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“…Though PSARP suggested by Pena et al continues to be the treatment of choice for ARM in children, in adult due to extreme rarity of incidence there is no recommended treatment and possibility of PSARP is yet uncertain [ 4 ]. There are isolated case reports of anorectal malformation in adults treated successfully with PSARP [ 4 , 5 ] but this approach involves surgically dividing the puborectalis component of levator muscles and muscle complex (which play a very important role in the continence mechanisms [ 6 ]), perineal body, and the perineal skin. This can cause wound complications like scar of the perineal skin bridge between the fistula and the new anus [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Anorectal Malformation: Paediatric Problem Presenting in Adult

Chavan

Chikkala

Das

et al. 2015

Case Reports in Surgery

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This is a case report of 22-year-old girl admitted with abdominal distension, vomiting, and chronic constipation since birth. Abdomen was distended, and perineal examination revealed imperforate anus with vestibular fistula (ARM). So far worldwide very few cases have been reported about anorectal malformation presenting in adulthood, and thus extremely little data is available in the literature about an ideal management of anorectal malformation in adults. In our case in the treatment instead of conventional procedure of posterior sagittal anorectoplasty (PSARP) anal transposition was done and till two years after the definitive treatment during follow-up patient has been doing well with Kelly's score of six. Our experience suggests that anal transposition provides satisfactory outcome in adults presenting late with anorectal malformation.

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“…Patients with this anomaly can continue to pass stools through vagina and can reach adult age group with only complaint of incontinence. There are very few case reports in literature of presentation of such anomalies in the postadolescent age group [3,7]. Ideal treatment and long-term results in such cases are unknown.…”

Section: Discussionmentioning

confidence: 99%

Anorectal Anomalies in Adults-Laparoscopic Management and Review of Literature

et al. 2012

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Anorectal malformations (ARMs) are one of the most common congenital anomalies dealt by surgeons. The reported incidence of ARMs range between 1:3,300 and 1:5,000 live births. These defects are invariably detected and treated in infancy or early childhood. There is a group of patients among these who have fistulous external opening from the rectum. These may not present in child hood and may continue to live with fecal incontinence till adult hood. One of such anomalies is rectovaginal fistulas which comprises of only 4% of all anomalies. Delayed management in such cases increases surgical and functional complications. Traditionally high and intermediate anorectal anomalies are treated by posterior sagittal anorectoplasty (PSARP). This involves cutting of sphincter muscles in the midline and then placement of rectum in the sphincter complex. The continence results of this operation are less than ideal. Laparoscopically assisted anorectal pull-through (LAARP) has potential advantage of precise placement of the rectum inside the sphincter complex without dividing and weakening the muscles, diminished soft tissue scarring around the rectum leading to improved rectal compliance. Three adult female patients with ARMs were managed through LAARP procedure. It involves dissection around rectum, identification and ligation of fistula tract, creation of neoanus and pull through of rectum into neoanus. Results-Continence was good in all our patients which they regained after 3 to 4 days of surgery. On follow up which ranged from 6 months to 2 years all were passing well formed stools 1-2 times a day and have symmetric anal contraction with strong squeeze on digital rectal examination. Conclusion-LAARP offers an excellent option to the patients of ARM over conventional posterior sagittal anorectal approach because if its theoretical advantages of early recovery and better continence. Long term followup is needed to substantiate these results.

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Posterior sagittal anorectoplasty: Primary repair of a rectovaginal fistula in an adult

Cited by 16 publications

References 8 publications

Primary anorectoplasty in females with common anorectal malformations without colostomy

Primary anorectoplasty in females with common anorectal malformations without colostomy

Anorectal Malformation: Paediatric Problem Presenting in Adult

Anorectal Anomalies in Adults-Laparoscopic Management and Review of Literature

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