Outcomes of Outcomes of Anerior sagittal Ano-Rectoplasty in the Management of Rectoves Tibular Fistula at Two Referral Hospitals

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Addis Abeba University


Background Over the years, a great deal of information has been acquired concerning the many variants of ARM. The current mortality for these anomalies for the most part has been very low and is related to associated anomalies and unfavourable chromosomal and genetic syndromes rather than the result of treatment of the ARM per se. In general, agreement has been reached regarding some embryologic and anatomic considerations, diagnostic evaluation, and preoperative assessment. Most investigators would agree that results are better following repair of low defects when compared to intermediate and high anomalies and those with cloaca. There remain several areas of controversy regarding the choice and timing of the procedure and methodology used to assess results. Certain poor prognostic factors have been identified, including abnormal sacrum, deficient pelvic innervation, poor perineal musculature and disorders of colonic motility. Objectives To investigate the overall outcome ASARP in the management of recto vestibular fistula in Tikur Anebessa Hospital & Minilik Referral Hospital , Ethiopia from January 1, 2015 to December 30, 2020 Methods A cross-sectional study design with convenience sampling technique was used on 74 patients who had ARM with RVF. Krickenbecks bowel function scoring system was used to assess the bowel functions score. Patients cards, follow-up charts and direct phone contacts with families were used to collect data from selected ARM patients who undergone ASARP in the two of the referral Hospitals from January 1,2015 to December 30, 2020. Result : In this study we do not found statistically significant associations between the type of operations and the occurrence of Post-operative early wound complications or anal stricture But the overall frequency of early post-operative complications more in two staged ASARP (14.8%) and anal stenosis is observed in the Three staged ASARP group more frequently (21%) . This study also found lower rates of screening for associated anomalies and higher rate of postoperative neo anal stricture (17.6%). Majority studied patient have an excellent bowel function (96.2%).



Anorectal malformation, Anterior Sagittal Anorectoplasty, Recto-Vestibular Fistula