scholarly journals Anterior sagittal anorectoplasty with external sphincter preservation for the treatment of recto-vestibular fistula: A new approach

2018 ◽  
Vol 23 (1) ◽  
pp. 4 ◽  
Author(s):  
MohamedIbrahim Elsawaf ◽  
MohamedS Hashish
Keyword(s):  
External Sphincter ◽  
Sphincter Preservation ◽  
New Approach ◽  
Vestibular Fistula ◽  
Anterior Sagittal Anorectoplasty

P81 Intraoperative MEP recordings from a urethral sphincter electrode for spinal conus tumour surgery and its importance

2019 ◽  
Vol 90 (3) ◽  
pp. e43.2-e43
Author(s):  
A Shaikh ◽  
LA Hilaya ◽  
G Wilma ◽  
A Forster ◽  
S Ross
Keyword(s):  
Anal Sphincter ◽  
Foley Catheter ◽  
External Sphincter ◽  
Motor Evoked Potential ◽  
Sphincter Preservation ◽  
Urinary Continence ◽  
Urethral Sphincter ◽  
Avant Garde ◽  
The Uk ◽  
Intraoperative Nerve Monitoring

ObjectivesTo emphasise the importance of motor evoked potential (MEP) recordings from a simple urethral sphincter electrode along with routine use of bulbocavernosus reflex recordings, anal sphincter and other lower limb muscle free running and stimulated EMG and MEP’s, and SEP techniques for sphincter preservation.DesignCase report.SubjectsPatients with conus or other spinal lesions at risk of postoperative sphincter disturbance.MethodsTranscranial ‘train of 5’ stimulation (5 pulses, interstimulus interval 4msec, 200 µsec pulse width) was applied, with recordings from the urethral sphincter (small electrode taped to Foley catheter to lie just inside the urethra, referred to nearby needle anteriorly in mons pubis) and anal sphincter (paired needle electrodes in both left and right sides of external sphincter).ResultsIntraoperative stimuli of structures during dissection at one point gave a motor response confined to the urethral sphincter suggesting that these fibres may have been considered non-functional and cut had these not been assessed separately. Urethral sphincter MEP’s during the dissection confirmed that these motor fibres remained in continuity throughout.. The patient was intact after tumour removal.ConclusionsThis is an avant-garde technique by which we managed to save the nerve supply to the urethral sphincter and eventually urinary continence which would have been compromised if separate urethral monitoring was not attempted along with usual intraoperative nerve monitoring. We believe its first in the UK.

scholarly journals Excision of the Levator Muscles With External Sphincter Preservation in the Treatment of Selected Low T4 Rectal Cancers

2002 ◽  
Vol 45 (12) ◽  
pp. 1697-1705 ◽  
Author(s):  
Claudio Fucini ◽  
Claudio Elbetti ◽  
Alessandra Petrolo ◽  
Donato Casella
Keyword(s):  
External Sphincter ◽  
Sphincter Preservation ◽  
Rectal Cancers

Bowel Functional Outcomes in Females With Perineal or Vestibular Fistula Treated With Anterior Sagittal Anorectoplasty

2015 ◽  
Vol 58 (1) ◽  
pp. 97-103 ◽  
Author(s):  
Kristiina Kyrklund ◽  
Mikko P. Pakarinen ◽  
Antti Koivusalo ◽  
Risto J. Rintala
Keyword(s):  
Functional Outcomes ◽  
Vestibular Fistula ◽  
Anterior Sagittal Anorectoplasty

Long-term results of anterior sagittal anorectoplasty for the treatment of vestibular fistula

2009 ◽  
Vol 44 (10) ◽  
pp. 1913-1919 ◽  
Author(s):  
Ashish Wakhlu ◽  
Shiv Narain Kureel ◽  
Raj Kumar Tandon ◽  
Avtar Kishen Wakhlu
Keyword(s):  
Long Term Results ◽  
Vestibular Fistula ◽  
Anterior Sagittal Anorectoplasty

scholarly journals Single stage Anterior Sagittal Anorectoplasty (ASARP) for Anorectal Malformations with Vestibular Fistula and Perineal Ectopic Anus in Females: A New Approach

1970 ◽  
Vol 30 (1) ◽  
pp. 37-43
Author(s):  
Ramananda Prasad Chaudhary ◽  
Bijay Thapa ◽  
Santosh Thana ◽  
Pradeep B Singh
Keyword(s):  
Bowel Function ◽  
Anorectal Malformations ◽  
Skin Incision ◽  
Single Stage ◽  
Lithotomy Position ◽  
Surgical Morbidity ◽  
Anterior Portion ◽  
Vestibular Fistula ◽  
Perineal Skin ◽  
Anterior Sagittal Anorectoplasty

Introduction: Despite a better understanding of the embryology, anatomy of anorectal malformations and of the physiology of continence, the management of children born with imperforate anus continues to be a surgical challenge and is still fraught with numerous complications and often leads to less than perfect qualitative results. Pediatric patients with recto-vestibular fistula have good prognoses in terms of bowel function when properly treated. Aim & Objective: The study was designed to assess the surgical morbidity of single stage Anterior Sagittal Anorectoplasty (ASARP). Methodology: This prospective study was carried for a period of 26 months. It included a total of 48 female patients (aged 0 - 14 years) with diagnosis of Anorectal Malformations (ARM) with vestibular fistula or perineal ectopic anus. In ASARP, Patient in lithotomy position, the anterior portion of sphincter muscles were cut through a midline perineal skin incision, rectum was separated from the vagina & then rectum was pulled through the center of these muscles. The perineal body was reconstructed and the normal appearance of perineum was achieved. Results: Short-term surgical outcome was satisfactory in all cases. No one needed colostomy. Conclusion: Single-stage ASARP is a good approach in experience hands for ARM with vestibular fistula and perineal ectopic anus in females and thereby complications and time involved in staged procedures including colostomy can be avoided. Key words: Anterior sagittal anorectoplasty, anorectal malformations, perineal ectopic anus, vestibular fistula. DOI: 10.3126/jnps.v30i1.2458 Journal of Nepal Paediatric Society Vol.30(1) 2010 37-43

Long-term outcome following loose-seton technique for external sphincter preservation in complex anal fistula

2004 ◽  
Vol 91 (4) ◽  
pp. 476-480 ◽  
Author(s):  
G. N. Buchanan ◽  
H. A. Owen ◽  
J. Torkington ◽  
P. J. Lunniss ◽  
R. J. Nicholls ◽  
...  
Keyword(s):  
Anal Fistula ◽  
External Sphincter ◽  
Sphincter Preservation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Complex Anal Fistula

scholarly journals Functional assessment of the patients with perineal and vestibular fistula treated by anterior sagittal anorectoplasty

2018 ◽  
Vol 15 (1) ◽  
pp. 36
Author(s):  
Naoki Hashizume ◽  
Kimio Asagiri ◽  
Suguru Fukahori ◽  
Shinji Ishii ◽  
Nobuyuki Saikusa ◽  
...  
Keyword(s):  
Functional Assessment ◽  
Vestibular Fistula ◽  
Anterior Sagittal Anorectoplasty
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