الفهرس 
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Abstract
Objectives: to estimate the incidence of postoperative constipation among patients with rectoperineal fistula treated with anorectoplasty using Krickenbeck classification for postoperative outcomes.
Patients and Methods: The study was conducted between January 2018 and August 2018. The study included patients with rectoperineal fistula who underwent sagittal anorectoplasty (SARP) in the last five years in two tertiary hospitals; Ain Shams University Children Hospital and Banha Specialized Children Hospital. We excluded patients who underwent operations other than SARP and patients having Currarino syndrome and sacral anomaly like hemisacrum and caudal regression. Krickenbeck classification was used for assessment of constipation before and after operation. A simple questionnaire was used for follow up assessment.
Results: We reviewed 60 patients’ files with rectoperineal fistula who were operated in the last five years. We excluded 20 patients for having operations other than SARP like posterior anoplasty and cut back. We have lost contacts of 10 patients. The study included remaining 30 patients (19 female and 11 male). Their age at time of repair ranged from 3m to 78 months with a median age of 7.5 months.
Rate of constipation in patients with rectoperineal fistula after SARP was 39%. There were 23 patients from 30 patients with rectoperineal fistula had constipation before repair; 14 patients of them (61%) were treated from constipation, and one patient (4%) got improved regarding constipation grade and frequency, while remaining 8 patients (35%) were still having the same degree of constipation. There were 7 children who had no constipation before and after repair. These results were statistically significant as measured using McNemar test. Postoperative soiling was recorded in 7 patients; all of them had pseudo-incontinence (ORSI).
Conclusion: Constipation is the cardinal complaint between patients with rectoperineal fistula. Based on this study, surgical repair of rectoperineal fistula is not only cosmetically treating the patients, but also improving the function (65% of constipated patients got improved).