Anorectal anomalies: a review of 49 cases.

A series of forty-nine cases of anorectal anomalies treated in the Department of Surgery, Singapore General Hospital, is reviewed. The incidence of ano-rectal malformation in the Singapore population is estimated to be one in 11,500 live births. There is a significant male preponderence with a ratio of 7 to 3. Supralevator lesions accounted for 55% of the cases and of this group, 31% had associated congenital anomalies. In contrast only 11% of the low anomalies had other congenital defects. All patients were treated surgically either by anoplasty for the low lesions or staged rectoplasty for the intermediate and high lesions. The results of surgery for the low anomalies were uniformly good. In the group with high anomalies 7 cases had a good results, 21 had a fair result with occasional soiling only, and 2 cases had a poor result with frank incontinence.