Posterior sagittal anorectoplasty in adults: secondary repair for persistent incontinence in patients with anorectal malformations.
OBJECTIVE
Posterior sagittal anorectoplasty, regarded as a standard surgical primary repair for anorectal malformations in infancy, was evaluated for effectiveness when performed as a secondary operation for establishing continence in the adult. The purpose of this review was to evaluate our results of performing posterior sagittal anorectoplasty in adult patients and to emphasize the extensive evaluation required to perform proper patient selection.


METHODS
From January 1, 1992, to December 31, 1996, eight patients with Grade 3 incontinence underwent posterior sagittal anorectoplasty. The ages ranged from 13 to 40 (mean, 26) years.


RESULTS
All patients had diverting stomas at the time of repair and all but one had restoration of intestinal continuity. Of eight patients who underwent posterior sagittal anorectoplasty, one failed secondary to rectal ischemia and retained a diverting stoma. Six patients had restoration of continuity. Five patients were continent and one had incontinence only to gas.


CONCLUSIONS
We have established that posterior sagittal anorectoplasty can effectively be used to establish continence as a secondary procedure for a select group of adult patients.
Simmang
C L
CL
University of Texas Southwestern Medical Center, Dallas 75235-9156, USA.
Huber
P J
PJ
Guzzetta
P
P
Crockett
J
J
Martinez
R
R
D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000002:abnormalities* / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods; D005242:Fecal Incontinence; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000002:abnormalities* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome