Various classifications of rectal and anal malformation have been suggested, but that of Ladd & Gross (1.934) has received widest recognition.
They described 4 types as follows .
Type. I incomplete rupture of -anal membrane´. or stenosis.
Type I Imperforate anus. Obstruction due ;to persistent membrane. Type lQ The rectal pouch ended blindly in or abovethe pelvis.
Type 1V Anorectal atresia. Anus and pouch normal but the rectal pouch ended blindly.
Browne (1955), however, classified imperforate anus into high and low types, according to´
their relation to the pelvic floor-"high" lesions above the estimated level of the pelvic floor "low"
lesions below the floor.
The result of surgical treatment in these cases have been variable and this has largely depended on the type of lesion present.
In reviewing a series of 55 cases of anorectal anomalies which we have been privileged to see during the course of the past 15 years, we have found that;
1. Both sexes were relatively equally affected (male; 29 & female; 26).
2. The most frequent type of congenital anorectal anomalies was Type 111 (84%). 3. Associated congenital anomalies involving other organ was 13% of cases.
4. Satisfactory result of primary definitive procedure was 83% and that of definitive procedure,
following initial colostomy was 80%, suggesting no differences between the procedures 67%.6.Overall mortality rate was 5.5%.
7. Transient urinary incontinence was noticed in 5 cases of group of abdomino-perineal pullthrough operation.
|