CONGENITAL POUCH COLON; OUR EXPERIENCE WITH SINGLE STAGE PROCEDURE.

Abstract

Objectives: To review our experience with single-stage management of congenital pouch colon (CPC) as regard to complications and continence. Study Design: retrospective study. Setting: Paediatric Surgery Bahawal Victoria Hospital Bahawalpur. Period: July 2011 to July 2017. Methodology: All the patients of anorectal agenesis that were diagnosed as case of CPC on history, clinical examination and supported by x-ray (invertogrm) admitted during the study period 2011 to 2017 were included. A total of 35 cases were managed with single stage procedure. All the patients were assessed for complications, mortality, and continence with Kelly’s scoring. Results: We managed 35 patients with average age 2.8 days ranging from 12 hours to 5 days. 29 (82,8%) were males and 6 (17.2%) females. In 31 (85.7%) patients, the association was with high anorectal agenesis, whereas, in 4(14.3%) patients with low ARM. At operation, type 1 CPC was in 4 (11.4%) patients, type II in 9 (25.7%), type III in 5 (14.2%) patients, and type IV in 17 (48.5%) patients. There were 2 (5.7%) deaths in our study; the reason was associated anomaly and sepsis. Wound infection was seen in 5 (14.2%) pts. anal stenosis in 2 pts. and mucosal prolapse in 1 pt. Continence was evaluated by the Kelly’s scoring and it showed good results. Conclusions: The results of SSP for various types of CPC are good as regards continence and cosmetics, with decrease rate of morbidity and mortality and hence it is recommended.