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Imperforate anus repair - Overview

Alternative Names

Anorectal malformation repair; Perineal anoplasty; Anorectal anomaly; Anorectal plasty

Definition of Imperforate anus repair:

Imperforate anus repair is surgery to correct a birth defect involving the rectum and anus.

An imperforate anus defect prevents most or all stool from passing out of the rectum.

See also: Imperforate anus

Description:

How this surgery is performed depends on the type of imperforate anus. The procedures are done under general anesthesia, which means the infant is asleep and feels no pain during the procedure.

For mild imperforate anus defects:

  • The first step involves enlarging the opening where the stool drains so stool can pass more easily.
  • Surgery involves closing any small tube-like openings (fistulas), creating an anal opening, and putting the rectal pouch into the anal opening. This is called an anoplasty.
  • The child must often take stool softeners for weeks to months.

Two surgeries are often needed for more severe imperforate anus defects:

  • The surgeon will create an opening in the skin and muscle of the abdominal wall and attach the end of the large intestine to the opening. Stools will drain into a bag attached to the abdomen. This is called a colostomy.
  • The baby is often allowed to grow for 3 - 6 months.
  • For the second procedure, the surgeon may make a cut in the abdomen to detach and move the colon to a new position. A cut is made in the anal area to pull the rectal pouch down into place and create an anal opening.
  • The colostomy will likely be left in place for 2 - 3 more months.

A major challenge for these repairs is finding, using, or creating nearby nerves and muscles so that the child can move the bowels normally.

Why the Procedure Is Performed:

The surgery repairs the defect so that stool can move through the rectum.

  • Reviewed last on: 12/11/2009
  • Kimberly G. Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Klein MD, Thomas RP. Surgical conditions of the anus, rectum, and colon. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 341.

Warner BW. Pediatric surgery. In: Townsend CM, Beauchamp RD, Eyers BM, Mattox KL, eds. Sabiston Textbook of Surgery, 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 71.

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