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ORIGINAL ARTICLE
Year : 2005  |  Volume : 8  |  Issue : 2  |  Page : 44-46

Correction of imperforate anus in girls without preliminary colostomy


Consultant Paediatric Surgeon, University of Ilorin Teaching Hospital, P.O. Box 5708, Ilorin, Nigeria

Correspondence Address:
J O Adeniran
P..O. Box 5708, Ilorin, Nigeria
Nigeria
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Source of Support: None, Conflict of Interest: None


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Background and Aim: Colostomy is socially unacceptable in many developing countries. Even when performed, morbidity and mortalities are high because most parents are illiterates, colostomy bags are not readily available and there are .no stomal nurses. This prospective study was, therefore, designed to assess the safety of correcting imperforate anus in girls without preliminarily diverting colostomy. Methodology: Twenty-one girls with imperforate anus and recto-vestibular fistula were entered into the study. Traditional large bowel preparations were done for 1 week, followed by Pena's posterior sagittal anorectoplasty. S yringe vents were used to protect the incisions for 10 days. Peri-operative cephalosporin and metronidazole were given. Results: Fourteen girls had intermediate anomalies, 7 had low anomalies. No other major detectable associated congenital anomalies. Washout through the fistula was easy. There were no particular problems with posterior sagittal anorectoplasty in prone positions. 1ucisions in 16 girls healed primarily although 4 patients had minor peri-anal excoriations; 2 girls had superficial wound infection, 2 had anal mucosal prolapse, 1 had recurrence of fistula. Conclusion: This study shows that girls with imperforate anus and recto-vestibular fistula usually sagittal anorectoplasty, protected with venting, without initial defunctioning colostomy. There are several advantages of a single operation, rather than multiples, epecially in developing countries.


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