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Background <p>Several surgical techniques have been described for the repair of anorectal malformations (ARM) in children.</p> Purpose <p>This work aimed to compare between Sphincter Saving Anorectoplasty (SSARP) and Posterior Sagittal Anorectoplasty (PSARP) in the management of patients with ARM.</p> Methods <p>This is a prospective randomized study was carried out on 20 patients with ARM. Candidates were randomly assigned into two equal groups: the SSARP group, which had SSARP, and the PSARP group, which had a classic PSARP. All patients were subjected to a standardized neonatal evaluation beginning with detailed antenatal, maternal, family, and perinatal history, clinical assessment, and perineal inspection for anal patency or fistula. Initial management, radiological evaluation, a proximal sigmoid double-barrel colostomy, preoperative assessment, and routine laboratory tests were repeated.</p> Results <p>There were no statistically significant variations among the SSARP and PSARP groups regarding fistula type distribution, intraoperative bleeding, postoperative infection, or bowel habit outcomes (<i>P</i> &gt; 0.05). Both groups showed comparable rates of complications and similar functional outcomes, including normal bowel habits in 80% of patients in each group. Though mucosal prolapse is slightly higher in SSARP. No cases of postoperative stricture or failures of centralization were observed in either group.</p> Conclusions <p>SSARP may represent a feasible alternative to PSARP in selected patients with ARM. However, larger studies with longer follow-up are required to confirm potential functional advantages related to sphincter preservation.</p>

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Comparative study between Sphincter-Saving Anorectoplasty (SSARP) and Posterior Sagittal Anorectoplasty (PSARP) for management of anorectal malformations in children

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月15日

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  • Ibrahim Mahran Abdelrahman,
  • Gamal Hassan El Tagy,
  • Omar Mohamed Mansour,
  • Mostafa Ahmed Gad

摘要

Background

Several surgical techniques have been described for the repair of anorectal malformations (ARM) in children.

Purpose

This work aimed to compare between Sphincter Saving Anorectoplasty (SSARP) and Posterior Sagittal Anorectoplasty (PSARP) in the management of patients with ARM.

Methods

This is a prospective randomized study was carried out on 20 patients with ARM. Candidates were randomly assigned into two equal groups: the SSARP group, which had SSARP, and the PSARP group, which had a classic PSARP. All patients were subjected to a standardized neonatal evaluation beginning with detailed antenatal, maternal, family, and perinatal history, clinical assessment, and perineal inspection for anal patency or fistula. Initial management, radiological evaluation, a proximal sigmoid double-barrel colostomy, preoperative assessment, and routine laboratory tests were repeated.

Results

There were no statistically significant variations among the SSARP and PSARP groups regarding fistula type distribution, intraoperative bleeding, postoperative infection, or bowel habit outcomes (P > 0.05). Both groups showed comparable rates of complications and similar functional outcomes, including normal bowel habits in 80% of patients in each group. Though mucosal prolapse is slightly higher in SSARP. No cases of postoperative stricture or failures of centralization were observed in either group.

Conclusions

SSARP may represent a feasible alternative to PSARP in selected patients with ARM. However, larger studies with longer follow-up are required to confirm potential functional advantages related to sphincter preservation.