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Discussion in 'All Categories' started by ANURAG KHANNA - Sep 25th, 2012 9:56 pm.
The above mentioned problem is diagnosed at the time of birth of male child of my brother (Born on 3rd Jan 2012). During the physical examination of the child after birth it was noticed by the doctor that the child has no anal opening.After getting the x-ray etc done, the doctor operated the child on the 2nd day after birth and have done "Colostomy" creating a path in the stomach so that faeces can pass through that path and advised that after 6-7 months when the child gain some weight and after carrying some other tests, if seems appropriate they will do surgery to create the right opening for the anus at it's normal place which seems to be done through "Laproscopic assisted pull through or LAARP or laproscopic anorectoplasty". Currently the child is of 7 months and on further tests done recently to check whether the procedure can be operated now on the advice of the doctor, it is found that the channel of passage of urine and the faeces or in other words presence of common channel of rectum and urinary tract. I want to take your advice regarding the above condition involving the possible treatment that can be adviced in this case, success chances after post-operative surgery and the complications that can occur including long term effects after this surgery on child and lastly about the life of the child as to whether he is able to live a normal life or not. I will also like to get the details, if possible, about similar surgeries performed by the doctors here in this hospital i.e. no. of similar cases/patients operated till date in India by the doctor(s)of this hospital,success rate,any abnormalities or problems occured in the patients operated later or complications faced, life pattern of the patients after the surgery for the next 1-5 years in case details are available and any other information which you want to share regarding it. I will appreciate your effort in furnishing information regarding these details and also regarding any other renowned doctor or hospital which can be consulted for better treatment of the child facing this problem as it all depends upon the surgery which if done with the most professional,experienced and competenet medical practitioners in their field that will going to decide about the life of the child. I will like to get your advice regarding the above medical problem and thankful to all of you for your guidance. I will if required be also like to schedule an appointment with you to discuss further on this case and to show you the reports of various tests, x-ray etc done on the child till date to let you know about all the details which can be helpful in advicing the further treatment required to be done to save the life of the child and to ensure that the child lives a healthy and normal life.

Thanks & Regards
Anurag Khanna
re: IMPERFORNATE ANUS by Sadhana - Oct 1st, 2012 10:59 am
Dear Anurag Khanna

Anorectal malformations in newborn comprise a wide spectrum of diseases that affect many boys and girls and can involve malformations of the distal anus and rectum, as well as the urinary and genital tracts.

Anorectal malformations occur in approximately 1 per 5000 live births. These type of enterovesical fistula is not uncommon and these malformations range from minor, easily treated defects that carry an excellent functional prognosis, to complex defects that are difficult to treat, are often associated with other anomalies, and carry a poor functional prognosis.

Laparoscopic correction of these anomoly is possible but exact prognosis any body can not predict. Many surgeon have seen and attempted to treat infants born with imperforate anus.

The decision to perform an anoplasty during the early newborn period or to delay the repair and perform a colostomy is based on physical examination findings in the newborn, the appearance of the perineum, and changes that occur during the first 24-36 hours of life.

Definitive repair is required many months after colostomy. I can not give any definitive guideline just on internet but I will advice you to keep faith on your pediatric surgeon and let them do the difinitive surgery if they have enough experience.

Selecting the experienced surgeon is very important because the future of the child depends on the correct anastomosis i.e anoplasty.

If a child who has undergone a pull-through procedure for imperforate anus and has small discrete bowel movements per day has good potential for future fecal continence. On the other end of the spectrum, a child who has fecal incontinence passes stool constantly without evidence of pushing or feeling with a typical bowel movement pattern is trainable, whereas a child with the pattern of fecal incontinence likely requires a bowel management program with a daily enema. The child with true fecal incontinence should not be expected to achieve voluntary bowel control immediately.

It is a complete chain of treatment though which you have to go but the good information is that in most of the cases as the child grows the normal activity returns back.

With regards
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