PROSPECTIVE STUDY TO COMPARE THE FUNCTIONAL AND COSMETIC OUTCOME OF NEUTRAL SAGITTAL ANORECTOPLASTY (NSARP) VERSUS ANTERIOR SAGITTAL ANORECTOPLASTY (ASARP) IN FEMALE INFANTS WITH VESTIBULAR FISTULA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 48
Abstract
BACKGROUND Imperforate anus with vestibular fistula is the most common form of anorectal malformation in females. In this anomaly, the development of the sphincteric muscle is usually normal and the fistula or the anus opens below the vaginal orifice in the vestibule near the posterior fourchette surrounded by moist mucous membrane rather than dry skin. The objectives of study were1. To assess the functional and cosmetic results of Neutral Sagittal Anorectoplasty and 2. To compare the outcome of Neutral Sagittal Anorectoplasty with Anterior Sagittal Anorectoplasty. MATERIALS AND METHODS This is a non-randomised controlled trial study carried out in the department of Paediatric Surgery of SVP Post Graduate Institute of Paediatrics, SCB Medical College, Cuttack, Odisha, over a period of two years from Nov 2010 to Oct 2012. Since study duration is short, we had to limit the sample size for convenience. 30 female infants between 3 months to 6 months of age with vestibular fistula, operated in the department were included in the study. Total 30 cases were taken for the study for convenience. This sample size was divided into two groups non-randomly and allocated to either Group A (n=15) or Group B (n=15) with 15 patients each. Group A Patients were subjected to Neutral Sagittal Anorectoplasty (NSARP) & Group B patients were subjected to Anterior Sagittal Anorectoplasty (ASARP). RESULTS NSARP has given better functional and cosmetic outcome than ASARP. The incision required is small. The perineal body remains untouched and a bridge of skin is left between the anterior part of the neoanus and vestibule. Constipation was more in ASARP group. Cosmetic results are better in NSARP group. CONCLUSION Functional and Cosmetic results are better in NSARP than ASARP.
Authors and Affiliations
Pramod Kumar Mohanty, Biswaranjan Mohapatra, Hiranya Kishor Mohanty, Pradeep Kumar Jena, Gadadhar Sarangi
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