Anorectal malformations will require one or more specialized types of corrective surgeries that will depend on the severity of your child’s condition. More than one surgery may need to take place over the course of several months to normalize and restore bowel function. Our highly experienced colorectal surgeons are trained in the latest surgical approaches for all types of anorectal malformations including implementing leading-edge, minimally-invasive techniques.
Surgical repair for anorectal malformations include:
A colostomy is a surgical procedure that creates an opening for the colon, or large intestine to excrete waste in a small bag located outside of the body. Most babies born with an anorectal malformation will need a temporary colostomy within the first few days of life. The colostomy will ensure the baby can properly pass stool, helps to normalize digestion and greatly reduces the risk of infection.
Posterior Sagittal Anorectoplasty (PSARP)
Anorectal reconstructive surgery, also known as posterior sagittal anorectoplasty (PSARP), is performed in order to connect the rectum to the anal opening as well as close any abnormal openings that may interfere with the ability to have a normal bowel movement. In cases where there is an absence of an anal opening, your surgeon will create a new one.
The majority of PSARP procedures are performed when a baby is between one and six months old. The type of PSARP performed will depend on the position of the rectum and anus (whether it is low or high), how well the sphincter muscles work, and if there are any abnormal openings (called fistulas) that need to be repaired. For appropriate cases, pediatric surgeons at Children’s National Hospital use minimally-invasive, laparoscopic techniques to help reduce the damage to surrounding structures and minimize pain post-surgery.
Your child’s colostomy will remain in place for approximately eight weeks following the reconstructive surgery to allow the rectum and anal opening to heal before coming in contact with any waste. When your child is ready and completely healed, the colostomy will be surgically closed. Within several days, they will begin passing stools on their own through the anus. At first, stools will be loose and occur frequently. To protect your child’s skin from diaper rash and irritation, safe topical treatments should be applied. As your child continues to heal, their stools will normalize, becoming firmer and less frequent.