Quality of Life in Children After Corrective Surgery for Anorectal Malformation at Kenyatta National Hospital

Abstract

Twenty five patients with Anorectal Malformation were enrolled in the study for assessment of Quality of Life after corrective surgery for Anorectal Malformation. Seventy two percent of the participants had good functional outcome , 12 percent had a fair outcome and 16% percent had a poor outcome. Low malformations have a better prognosis compared to high malformations i.e. 92% vs. 33% respectively. Redo surgery is the biggest cause of unfavourable outcomes. Only 37.5% achieved normal bowel control after redo procedures. Eight participants had redo surgeries. Females had better outcomes than males probably because more females had lower malformations compared to males. All females enrolled in the study had recto vestibular fistulae. Vertebral anomalies were found in two participants but this however did not affect their outcome. This is a rare finding because vertebral anomalies are known to have poor outcomes due to associated poor innervation of the anal sphincter and poor development of the sphincter muscles. The Paediatric surgical department at KNH is evolving and adapting standards as practiced elsewhere worldwide. The old patients had abdominal perineal surgery, later Posterior sagittal anorectoplasty was adapted and now more surgeons are practising Anterior sagittal anorectoplasty with very good results.