Abdominal Perineal Anus Plasty For The Treatment Of High Anal Atresia Clinical Value And The Analysis Of The Factors Influencing The Function Of The Anus

Objective: Discussion of abdominal perineal anus anoplasty treatment ofhigh anal atresia and related factors affecting the value of re-evaluation of itsclinical application.Methods:From June2001to October2013, total40patients (36males,4femals) with high imperforate anus were treated by staging abdominal perinealanoplasty. All patients were followed up for a complete clinical data. The meanage was9.68±10.5months, the average weight of7.047±1.91Kg.Initialcolostomy was performed in all patients during the newborn period,10withdescending colon colostomy,27with sigmoid colostomy,3with transversecolon colostomy. Reconstruction anus in27cases with sigmoid colon,10caseswith rectum,3cases with ascending colon. All patients were followed up for0.5-12.5years (average3.3years). All patients were evaluated with Kelly scoreto evaluate the anal function of postoperative. And discussion5factors that mayaffect the anal function of postoperative: postoperative follow-up time, age atsurgery, weight at surgery, wound healing and the bowel position when rebuilding anus.Result: In early postoperative, there were8cases of incision infectionpatients（20%），there were11cases of intestinal mucosal prolapse （27.5%），there were1case of urinary incontinence(2.5%). All patients were evaluatedwith Kelly score, rated as excellent in25cases(62.5%)，rated as good in9cases(22.5%)，rated as poor were6cases(15%). Patients in the group followedup by less than2years have satisfactory fecal conditions of10patients, themedian Kelly score was4.29±1.75，excellent rate of76.5%.Patients who werefollowed for more than2years have satisfactory fecal conditions of15people,the median Kelly score was4.56±1.3, excellent rate of91.3%. Excellent rate ofthe two groups showed no statistically significant (P＞0.05).With the extensionof time after surgery, anal function improved. Surgery were older than6monthsof postoperative anal function better than surgery in patients younger than6months(P＜0.05). Incision healing of postoperative anal function in patientswith good better than those of patients with postoperative incision infection(P＜0.05). Anal reconstruction in the proximal colon position anal bowel functionhigher than in the distal intestine excellent，Had no effect on weight when theoperation for anal function（P＞0.05）.Conclusion: Abdominal perineal anoplasty is the treatment of high anal atresiaand effective surgery, the surgical method is simple, reliable, and this surgicalapproach still exists to promote the significance and application value. Theprocedure should be completed after six months of age, the position of the colonand anal reconstruction surgery healing anal incision has a significant impact on postoperative anal function.