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KMID : 0360919680110070587
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Journal of the Korean Medical Association
1968 Volume.11 No. 7 p.587 ~ p.594
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IMPERFORATE ANUS
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閔丙哲/Kim, Pyung Chul
李萬澤/金光子/李世淳/Yi, Man Taik/Kim, Kwang Woo/Lee, Sae Toon
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Abstract
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1. Fifty(50) cases ofimperforate anus seen at the Yonsei university and Seoul national universl hospitals between the ´period January 1961 to June 1964 are reviewed.
2. Sex ratio, type of imperforate anus and incidence of associated fistulas were similar to the figures reported in literatures. Associaed congenital anomalies involving other body system was recorded in 20% of the cases.
3. Following procedures were employed: Perineal Anoplasty (10 cases), Abdomino-Perineal Pull through, one stage (20 cases), Abdonimo-Perineal Pull-through, two stages, (10 cases) and Colostomy alone (4 cases). Four (4) cases received no surgical treatment, one had dilatation only and the remaining one case underwent ileostomy for what appeared to be imperforate anus associated with congenital megacolon involving entire colon. Histological confirmation is lacking, however.
4. Overall mortality rate was 20% and was the highest among thosewhounderwent one stage abdominoperineal pull-through operations. Immediate complications included injury to lower urinary tract, intestinal obstruction and sepsis. Two significant, delayed complications were stricture at the site of muco-cutaneous anastomosis (anus) and malignant constipation. The former was more common folio wing perineal anoplasty while persitant constipation occured in many caseswho underwent abdominoperineal pull-through operations.
5. In cases where abdomino-perineal procedure need to be employed, it is our strong feeling that colostomy only should be done during these early infancy period, delaying the definitive procedure for about a year. We belive this practice will go a long way toward improving the functional results. of new anus which must serve errorlessly for many, many years. Mortality from surgery also can be lowered at least by 50% with such delay.
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