Anorectal Malformations Management and Outcome: An Observational Study

Introduction: During the last decade and a half, there has been a considerable refinement in the surgical management of Anorectal Malformations (ARM). Surgeons either employ primary definitive repair in a single stage or the traditional three-stage repair. Aim: The present study describes the management and outcome of ARM at the Surgery Department of a tertiary care hospital from the Marathwada region of Maharashtra. Materials and Methods: It is a prospective, observational and descriptive study. All cases of ARM admitted in Department of Surgery, GMCH Aurangabad during the study period (September 2013 to November 2015) were enrolled. 105 cases were included as per the criteria during the study period. Management and outcome were described with respect to the treatment modality used, complications and related details. Results: Out of 105 cases of ARM, one case succumbed to death. Out of 104 live babies, 15 cases were managed by primary single stage anoplasty by PSARP. From the rest 89 babies with initial colostomy, 39 babies were later managed by definitive repair with PSARP, and 5 babies were managed with ASARP. Ten cases did not follow up for further management, while 35 cases were waiting to be operated. Among the 54 operated cases of PSARP, the most common complication observed was perineal excoriation seen in 11 (20.4%) cases, wound dehiscence in 8 (14.8%) cases, wound infection in 7 (13%) cases and constipation, mucosal prolapse in 1 (1.9%) case each. Out of five cases operated by ASARP, 2 (40%) cases developed wound dehiscence and required resuturing. Conclusion: Posterior Sagittal Anorectoplasty (PSARP) was the preferred definitive operative treatment and the results were found to be satisfactory.