Evolution of management of anorectal malformation through the ages

Introduction: Anorectal malformations comprise a wide spectrum of diseases, which can affect boys and girls, and involve the distal anus and rectum as well as the urinary and genital tracts. They occur in approximately 1 in 3500 to 5000 live births. Since the early era of its management, its treatment has gone through an enormous phase of evolution leading from gloomy outcome in the past to nearly 100% survival in the modern era. Material and Methods: The literature on anorectal malformation was extensively reviewed for exploring the evolution of surgery for anorectal malformations. The management of anorectal malformation for the last 20 years at our center is presented. The results of the traditional staged repair compared to single-stage repair are discussed. Result: The surgical approach to repairing these defects changed dramatically in 1980 from sacroperineal to posterior sagittal anorectoplasty. Now it is time to shift toward single-stage repair whenever possible which has equivalent or better results yet less morbidity than the staged repair.