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Purpose <p>This study aimed to evaluate the mid-term functional and cosmetic outcomes of perineal body–sparing trans-sphincteric anorectoplasty (TSARP) in patients with anal atresia and rectovestibular fistula.</p> Methods <p>Patients with anal atresia and rectovestibular fistula who underwent perineal body–sparing TSARP between 2018 and 2024 were retrospectively reviewed. All procedures were performed by a single pediatric surgeon. Demographic data, presence of colostomy, perioperative complications, postoperative first-feeding time, and functional outcomes were recorded. Functional outcomes in patients were assessed using the Krickenbeck classification<b>.</b></p> Results <p>Twenty-six patients underwent perineal body–sparing TSARP. One-stage repair was performed in 16 patients (61.5%), whereas 10 (38.5%) had a protective colostomy. The median age at operation was 40&#xa0;days (range 2&#xa0;days–7&#xa0;months). Posterior vaginal wall injury occurred in two patients and was repaired uneventfully. Two patients developed wound infection that resolved with local wound care. The mean follow-up duration was 3.25&#xa0;years. Among 18 patients older than 3&#xa0;years old, voluntary bowel control was present in 15 patients (83.3%). Constipation occurred in seven patients, and no patient developed soiling.</p> Conclusion <p>Perineal body–sparing TSARP appears to be a safe and effective technique for rectovestibular fistula, providing low complication rates with satisfactory functional and cosmetic outcomes.</p>

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Perineal body–sparing transsphincteric anorectoplasty (TSARP) for rectovestibular fistula: Mid-term functional outcomes from a single center

  • 期刊论文

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  • 发表日期：

    2026年6月15日

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  • Berat Dilek Demirel,
  • Başak Dağdemir Ezber,
  • Beytullah Yağız

摘要

Purpose

This study aimed to evaluate the mid-term functional and cosmetic outcomes of perineal body–sparing trans-sphincteric anorectoplasty (TSARP) in patients with anal atresia and rectovestibular fistula.

Methods

Patients with anal atresia and rectovestibular fistula who underwent perineal body–sparing TSARP between 2018 and 2024 were retrospectively reviewed. All procedures were performed by a single pediatric surgeon. Demographic data, presence of colostomy, perioperative complications, postoperative first-feeding time, and functional outcomes were recorded. Functional outcomes in patients were assessed using the Krickenbeck classification.

Results

Twenty-six patients underwent perineal body–sparing TSARP. One-stage repair was performed in 16 patients (61.5%), whereas 10 (38.5%) had a protective colostomy. The median age at operation was 40 days (range 2 days–7 months). Posterior vaginal wall injury occurred in two patients and was repaired uneventfully. Two patients developed wound infection that resolved with local wound care. The mean follow-up duration was 3.25 years. Among 18 patients older than 3 years old, voluntary bowel control was present in 15 patients (83.3%). Constipation occurred in seven patients, and no patient developed soiling.

Conclusion

Perineal body–sparing TSARP appears to be a safe and effective technique for rectovestibular fistula, providing low complication rates with satisfactory functional and cosmetic outcomes.