Abstract
Posterior sagittal anorectoplasty is a marked change in treatment of anorectal malformations and differs fundamentally from previous techniques. In 1991 -1996 86 patients (51 boys and 35 girls) aged 1 day to 22 years were operated.
A primary operation was performed in 65 patients, a secondary one in 21 patients. In primary operations posterior sagittal anorectoplasty was used in 50 patients, in 3 cloacal malformations it was extended by reconstruction of the vagina and urethra.
Fifteen patients were operated by other techniques. Posterior sagittal anorecto (vaginourethro) plasty was used in all 21 reoperated patients.
Of 65 patients with primary operations one patient died from aspiration bronchopneumonia four years after operation. The patient had also an operation on account of oesophageal atresia.
Three patients were reoperated. The continence of patients after primary operations is satisfactory, 5 - 6 points on Kelly's scale.
In 19/21 reoperated patients the continence is 3 - 5 points according to Kelly. In two patients no substantial changes were recorded, one was reoperated twice.
As compared with pull-through techniques the posterior surgical method of anorecto (vaginourethro) plasty is excellent. It cannot be used however without adequate experience.