Fistulectomy and anoplasty for low imperforate anus with anoperineal fistula in boys

Purpose To present our operative technique for the treatment of anoperineal fistula, discussing its advantages in comparison with other methods of treatment. Patients and methods This study included 35 neonate boys, 34 were full term and one was preterm. Their age ranged from 1 to 4 days, and they were diagnosed to have low imperforate anus with anoperineal fistula, without associated major anomalies. They were treated by fistulectomy and anoplasty. Results The operative time ranged from 25 to 40 min. The operation was completed successfully in all patients. All patients started gradual oral feeding 2 h postoperatively and were discharged after 24–48 h on oral feeding. Postoperative stricture occurred in two patients, one responded to dilation and the other needed redo surgery by a simple cutback technique. Continence could be assessed in 23 patients whose follow-up periods were longer than 3 years. Twenty-one patients had a good score and two had a fair score. No patients had a poor score. Conclusion Our approach has the following advantages: (i) the operation is simple and easy to perform. (ii) It has a minimal complication rate, with a good cosmetic and functional outcome. (iii) Anorectal function was not adversely affected in patients with anterior position of the anal orifice.Keywords: anorectal anomalies, anoperineal fistula, low imperforate anus