Shehata Sherif M K
Section of Pediatric Surgery, Department of Surgery, Tanta University, Tanta, Egypt.
Pediatr Surg Int. 2009 Oct;25(10):863-8. doi: 10.1007/s00383-009-2434-7.
Prospective randomized comparison of the functional and cosmetic results of anterior sagittal anorectoplasty (ASARP) and posterior sagittal anorectoplasty (PSARP) in the management of intermediate anorectal malformations (ARMs) in girls was performed.
Thirty-eight girls with intermediate ARMs were randomly allocated to group A treated by ASARP technique and group B treated by PSARP technique: 14 girls from each group passed 30-month age for early functional assessment by Templeton and Holschneider scores, 18 cases passed 55 months for late functional evaluation. Results were compared statistically where P value < or = 0.05 was considered significant.
Cosmetic satisfaction was higher in ASARP group with a median score of 3 compared to 2 in PSARP group. Functional results were assessed early at median of 33.5 months post-repair where Templeton score was 4 versus 3.75 and Holschneider score was 11 versus 11. Late functional assessment was done for 8 cases from each group where Templeton score was 4 versus 4, while Holschneider score was 12 versus 11.
ASARP is an optimal technique for treatment of intermediate ARM in girls. Cosmetic results were superior to PSARP. Despite the observations that functional results give higher scores in ASARP group versus PSARP group, no statistical significance could be reached.
对前矢状位肛门直肠成形术（ASARP）和后矢状位肛门直肠成形术（PSARP）治疗女童中度肛门直肠畸形（ARM）的功能和美容效果进行前瞻性随机比较。
38例中度ARM女童被随机分为A组（采用ASARP技术治疗）和B组（采用PSARP技术治疗）：每组14例女童满30个月，采用Templeton和Holschneider评分进行早期功能评估，18例满55个月进行晚期功能评估。对结果进行统计学比较，P值≤0.05被认为具有统计学意义。
ASARP组的美容满意度更高，中位数评分为3分，而PSARP组为2分。术后中位时间33.5个月时进行早期功能评估，Templeton评分为4分对3.75分，Holschneider评分为11分对11分。每组8例进行晚期功能评估，Templeton评分为4分对4分，Holschneider评分为12分对11分。
ASARP是治疗女童中度ARM的最佳技术。美容效果优于PSARP。尽管观察到ASARP组的功能结果评分高于PSARP组，但未达到统计学意义。
