Single Stage Posterior Sagittal Anorectoplasty of Vestibular Fistula at a Tertiary Care Centre

Background: ARM is a prevalent congenital defect of the anorectum in female patients; in the majority of cases, it is vestibular fistula. Conventionally treated over several phases using colostomy, this method is associated with morbidity, expense and psychological pressure. Colostomy-free single-stage posterior sagittal anorectoplasty (PSARP) has the potential advantages of less invasive interventions and enhanced continence by early ano-cerebro-cortical reflex development. The paper evaluates its safety and effectiveness in a tertiary care environment. Materials & Methods: The case series was prospective and was held between September 2018 and August 2020 at Medical College Hospital Kolkata. Twenty female patients with vestibular fistula (15 anovestibular, 5 rectovestibular) aged 6 weeks to 3 years (median 6 months) were selected after ruling out pouch colon and lifeincompatible anomalies using barium enema, echocardiography and ultrasonography. Preoperative preparation consisted of immunisation completion, bowel cleansing by use of polyethylene glycol and antibiotics. The PSARP was done under general anaesthesia in prone position with careful rectal-vaginal separation and an