SAJS NEW.indd

Anorectal malformations (ARMs) affect about 1 in 5 000 liveborn infants. For those with high or intermediate defects (supra-levator or levator-level defects), colostomy in the newborn period is life-saving. However, long-term quality of life after construction of a neo-anus and colostomy closure is still unsatisfactory. In many cases, this can be attributed to complexity of the lesion, a high rate of associated malformations (40 60%) and poor socio-economic environment. Type of lesion, surgical management and quality of long-term follow-up play a major role. Advances in the management of ARM include the Wingspread initiative and the resulting standardisation of classification and evaluation. The introduction of the posterior sagittal anorectoplasty (PSARP) by Pena in 1981 significantly improved A comparison of laparoscopic-assisted (LAARP) and posterior sagittal (PSARP) anorectoplasty in the outcome of intermediate and high anorectal malformations