Add like
Add dislike
Add to saved papers

Bowel function following primary repair of anorectal malformations at Kenyatta National Hospital.

OBJECTIVES: To evaluate bowel function following primary repair of anorectal malformation.

DESIGN: A ten-year retrospective study.

SETTING: Kenyatta National Hospital, Nairobi, Kenya.

SUBJECTS: All patients with anorectal malformations attended to at Kenyatta National Hospital (KNH) within the study period who had posterior sagittal repair as a primary definitive procedure. All the children were over three years of age, toilet trained, and had their colostomies closed with an adaptation period of at least six months.

RESULTS: Posterior sagittal repair was used to repair anorectal malformations in 352 patients. One hundred and ninety three patients were evaluated. Overall voluntary bowel movement (VBM) was achieved in 71.5% of the patients, soiling was present in 21.2% of the patients and constipation in 7.3% of the patients. More than seventy nine per cent of children who had their colostomy fashioned before the age of one month achieved VBM, while 61.1% of the patients achieved VBM when the colostomy was fashioned after five years. Overall, 77.0% of the females achieved VBM compared to 63.8% of males. Patients with a perineal fistula achieved VBM in 79.1% of males and 75.0% of females, 76.0% with vestibular fistula, 73.9% with a recto-urethral fistula, 56.0% of anorectal anomalies without a fistula, 25.0% of vaginal fistulae and 12.5% in vesical fistulae. Overall patients with sacral defects achieved VBM in 25.9% compared to 78.9% in patients with a normal sacrum. The patients with low anomalies achieved VBM in 75.4% compared to 46.1% with high anomalies.

CONCLUSIONS: Posterior sagittal repair has been used to repair all anorectal malformations and has improved the quality of life of our patients, with better functional results expected in female patients, early colostomy fashioning and definitive repair, low or simple anomalies, and absence of sacral defects. The repair was associated with low morbidity and mortality.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app