Imperforate anus repair

Definition

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.

Alternative Names

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

Description

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

For mild imperforate anus defects:

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

Your child’s surgeon can tell you more about the exact way the surgeries will be done.

Why the Procedure Is Performed

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

Risks

Risks from anesthesia and surgery in general include:

Risks of this procedure include:

Before the Procedure

Follow instructions on how to prepare your baby for the surgery.

After the Procedure

Your baby may be able to go home later the same day if a mild defect is repaired. Or, your baby will need to spend several days in the hospital.

The health care provider will use an instrument to stretch (dilate) the new anus. This is done to improve muscle tone and prevent narrowing. This stretching must be done for several months.

Outlook (Prognosis)

Most defects can be corrected with surgery. Children with mild defects usually do very well. But, constipation may be a problem.

Children who have more complex surgeries still usually have control of their bowel movements. But, they often need to follow a bowel program. This includes eating high-fiber foods, taking stool softeners, and sometimes using enemas.

Some children may need more surgery. Most of these children will need to be followed-up closely for life.

Children with imperforate anus may also have other birth defects, including problems with the heart, kidneys, arms, legs, or spine.

References

Kliegman RM, Stanton BF, St Geme JW III, Schor NF. Surgical conditions of the anus and rectum. In: Kliegman RM, Stanton BF, St Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 344.

Levitt M, Pena A. Imperforate anus. In: Holcomb GW, Murphy JP, Ostlie DJ, eds. Ashcraft's Pediatric Surgery. 6th ed. Philadelphia, PA: Elsevier; 2014:chap 35.