Functional Outcomes Following Posterior Sagittal Anorectoplasty According to Pena for High and Intermediate Anorectal Malformations: A Cross-Sectional Study at Charles De Gaulle University Hospital in Ouagadougou

Abstract

Introduction: Anorectal malformation (ARM) is a rare congenital anomaly for which posterior sagittal anorectoplasty (PSARP) according to Pena is the standard procedure. The main postoperative complication remains anal incontinence. The primary objective of this study is to evaluate functional outcomes following posterior sagittal anorectoplasty (PSARP) according to Pena in the pediatric surgery department at Charles de Gaulle University Hospital in Ouagadougou. Patients and Methods: This is a descriptive cross-sectional study conducted in the pediatric surgery department of the Charles de Gaulle University Hospital from January to April 2022, involving all patients with high or intermediate ARM who underwent the three-stage surgical procedure between January 2010 and December 2017. Continence was assessed according to the Krickenbeck criteria over an average follow-up period of 8 years. Results: We included 32 patients, of whom 24 (75%) had high-grade ARM and 8 (25%) had intermediate-grade ARM. Voluntary stool passage was observed in 26 patients (81.25%), fecal soiling in 18 patients (56.25%), including 11 with grade 1 soiling, 4 with grade 2 and 3 with grade 3 soiling. Constipation was also noted in one patient (3.13%). Conclusion: Pena's PSARP provides acceptable functional outcomes for the management of high and intermediate ARM in our setting. Keywords:ARM, anorectoplasty, incontinence.