Complications Following One-Stage Repair of Intermediate Anorectal Anomalies in children

Background: To assess complications associated with one-stage repair of intermediate anorectal anomalies in boys and rectovestibular fistula in girls. Patients and Methods: All patients seen between 2000 and 2005 at the University Teaching Hospital, Ilorin, Nigeria, with anorectal anomalies who had posterior sagittal anorectoplasty without initial defunctioning colostomy were retrospectively re-viewed. Presenting complaints, initial investigations, pre-operative management, intraoperative and postoperative complications and period of follow-up, were extracted from patient's records. Results: There were 51 patients (23 boys and 28 girls). Age range for boys was 3-5 days (mean 3.5 days), and for girls 6 months to 7 years (mean 11 months). There was no complication in 87% of boys and 82.1% of girls. Immediate postoperative complications included perianal skin excoriations, and superficial wound dehiscence. Late complications included anal mucosal prolapse and anal stenosis Conclusion: With good large bowel preparation, adequate preoperative resuscitation, intra-operative protection of the posterior sagittal wound with syringe vent, and good choice of peri-operative antibiotics, it is safe to perform posterior sagittal anorectoplasty without colostomy on children with intermediate anorectal anomalies.