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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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Year : 2000  |  Volume : 5  |  Issue : 1  |  Page : 10-13

Neonatal PSARP Versus staged PSARR :a comparative analysis.


Department of Pediatric Surgery PGIMER, Chandigarh-160012, India

Correspondence Address:
BN Mishra
Department of Pediatric Surgery PGIMER, Chandigarh-160012
India
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Source of Support: None, Conflict of Interest: None


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ABSTRACT: Background: The conventional treatment for high anorectal malformations requires the reconstruction of a neoanus involving a staged operative approach. We tried to prospectively compare the results of a single-stage neonatal posterior sagittal anorectoplasty, with the conventional 3-stage procedure, in the high and the intermediate anorectal malformations. Patients and Method: Thirty four cases of male anorectal malformations, having high or intermediate anomalies, and less than 48 hours old with good sacrum, were included in the study. In 14 cases neonatal posterior sagittal anorectoplasty (PSARP) without backup colostomy was done. In the other 20 cases neonatal sigmoid colostomy was followed by posterior sagittal anorectoplasty and subsequent colostomy closure. The results in respect of mortality, morbidity and continence (according to the Kiesewetter criteria) were compared after 12 months. Results: There were 4 early deaths in the neonatal PSARP group. Wound infection, bowel retraction and urethral injury were the complications. The final assessment for continence could be made only in 7 neonatal cases and 14 staged cases. In the neonatal group, 2 had good, 4 fair and 1 poor continence. In the staged PSARP group, 9 had good, 4 fair and 1 poor continence. Conclusion: Staged repair had a better outcome in our center.






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  2005 - Journal of Indian Association of Pediatric Surgeons | Published by Wolters Kluwer - Medknow 

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