Complications of Anorectal Surgery in Children in Ile Ife, Nigeria

Abstract Background: Complications following anorectal surgeries in children are relatively frequent but are preventable. There is lack of information regarding the frequencies and complications of anorectal surgery in our environment. This study determined the occurrence and management of complications associated with anorectal surgery in Ile Ife, Nigeria. Methods: A retrospective review of anorectal surgery in children at the Obafemi Awolowo University Teaching Hospital, Ile Ife, Nigeria over a 10 year period (January 1993 to December 2002) Results: One hundred and thirty-seven anorectal surgical procedures were performed on 108 children. There were 74 males and 34 females. The mean age at surgery was 1.9years (range 1day to 15 years). The most common indication for anorectal surgery was Hirschsprung's disease in 51 children (47.2%) followed by anorectal malformations in 49 children (45.4%). Both conditions accounted for over 92% of the surgical indication. The surgical procedures performed included rectal biopsy 38%, posterior sagittal anorectoplasty 35.8%, and Swenson's pullthrough 21.2%, and Thiersch procedure 2.9%, excision of anal wart and suturing of anorectal laceration 0.8%. There were 50 complications observed in 34(31.5%) patients and all occurred following either Swenson's pullthrough or posterior sagittal anorectoplasty. Most of the complications were treated conservatively with satisfactory outcome but 12 of the 34 (35.3%) patients required further surgical intervention. There were 5 mortalities but in only one patient was the death directly linked to the complication of the main surgery. Conclusion: Complications following anorectal surgery in our environment is frequent but most can be managed conservatively. A few of the patients will require further surgical intervention. Attention to surgical details could have prevented some of these complications.