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Recto-Vestibular Fistula: Single Stage TFARP (Trans Fistula Anorectoplasty) without Colostomy-our Experience

Rajesh Gupta* , Rajesh Gupta* , Archika Gupta** , Varun Agarwal*** , Anjali Gupta****

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New Indian Journal of Surgery 7(1):p 9-12, January - April 2016. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.7116.2

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Abstract

 Background: Vestibular fistula is the most common type of anorectal malformation seen in females and it can be of low variety which is an anovestibular fistula for which a cut back is good enough, but usually an intermediate variety is seen that is called rectovestibular fistula. Standard surgical treatment for this anomaly is either ASARP (Anterior sagittal anorectoplasty)  or PSARP(Posterior sagittal anorectoplasty). We have adopted a technique of Transfistula Anorectoplasty, which doesn’t divide the sphincteric complex. Materials and Methods: The current study involves 24 cases of rectovestibular  fistula which were treated by primary TFARP without colostomy. We analysed the functional and cosmetic results with this method in our study. Results: Functional results were good in all patients except one which had complete retraction of rectum and needed a colostomy and revision of procedure. The cosmetic result was good with an almost normal looking perineum in most cases as the perineal body was not divided . However constipation was the major problem in majority of cases. Conclusion: We found TFARP a very useful and simple procedure with good cosmetic and functional results saving the patients from a colostomy. 

Keywords: Rectovestibular Fistula; Colostomy; Anorectal Malformations; Transfistula Anorectoplasty.

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.7116.2

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