Outcome of Muscle Complex Saving PSARP (MCS PSARP): 3 Years Experience in a Tertiary Pediatric Hospital in Bangladesh

Md. Sabbir Karim*, Khalid Mahmud, Nazmul Islam, Sultana Parvin, Jiaul Reza and Umme Habiba Dilshad

Division of Pediatric Surgery, Dhaka Shishu Hospital, Bangladesh Institute of Child Health, Bangladesh

^*Correspondance to: Md. Sabbir Karim 

 PDF  Full Text DOI: 10.25107/2474-1647.3078

Abstract

Background: Anorectal malformation is one of the most frequently encountered problems in pediatric surgery. A modification in the treatment of anorectal malformation was inevitable over 19th and 20th century until Devries and Pena proposed PSARP at 1982. Pena proposed a longitudinal incision from tip of the coccyx to the proposed anus which ensures complete visualization of the lower rectal pouch. But it needs to cut the muscle complex posteriorly on the midline. But our proposed technique ensures the placement of the lower rectal pouch in the center of the sphincter system. Objective: To see the outcome of muscle complex saving PSARP in the treatment of high and intermediate variety of anorectal malformation. Materials and Method: Total 31 patients were operated by muscle complex saving PSARP from Jun 2017 to Jun 2020. Intermediate and high variety of anorectal malformation with or without fistula from both sex were included in the study. Every patient underwent muscle complex saving PSARP under general anesthesia. Results: The mean age of the patients were 29.56 ? 14.40 months, ranges from 9 to 52 months. 15 out of 31 patients underwent following MCS PSARP. Among these 15 patients 12 (80%) had good bowel control, 2 (13.33%) had fair and 1 (6.67%) patient had poor bowel control. Mean operation time was 77.97 ? 6.78 minutes. Conclusion: Muscle complex saving PSARP is the modification of Pena?s classic PSARP with minimum morbidity. As it ensures direct visualization of the muscle complex and placement of lower rectal pouch in the center of the sphincter which is one of the key factor for low morbidity

Keywords

Muscle complex; PSARP: Anorectal

Cite the article

Md. Sabbir Karim, Mahmud K, Islam N, Parvin S, Reza J, Dilshad UH. Outcome of Muscle Complex Saving PSARP (MCS PSARP): 3 Years Experience in a Tertiary Pediatric Hospital in Bangladesh. Clin Surg. 2021; 6: 3078..