In NSARP group, 6 patients had excellent cosmetic score of 3 with parents fully satisfied as compared to 4 patients in ASARP group who recorded a score of 3.
Many surgical procedures are used for treatment of anovestibular and rectovestibular fistulae, which include cut back, perineal anal transposition, Y-V plasty, posterior anal transfer, colostomy followed by PSARP, ASARP, NSARP. [5, 6]
NSARP technique as an extension of PSARP described by Dave has the advantages of posterior sagittal incision with better delineation of anatomy without cutting the levator muscle and it also preserved the perineal skin.
The present study designed this non-randomized controlled trial study to compare the functional and cosmetic results of NSARP and ASARP in 30 female infants with VF operated in breast feeding age (Between 3-6 months) in single stage when the stool is semisolid.
This study has 15 patients in each group of NSARP and ASARP.
The median operative age is 137.2 days in NSARP group where as it is 141.1 days in ASARP group, most cases in either group were operated in the first 6 months of life.
The mean operative time was less for NSARP as compared to ASARP (85 mins VS 91 mins).
In addition, in this study the feasibility of one stage repair of VFs whether NSARP or ASARP is confirmed as documented in former reports.
Operative vaginal wall opening was less frequent in NSARP group.
The reinforcement of the anterior rectal wall after it was thinned out during separation from vaginal was required in two cases each of ASARP group and NSARP group which was comparable to other studies.
Despite that the same pre and peri-operative protocols were implemented to both groups of patients, NSARP group has lower infection rate than ASARP group.
During the time of functional assessment, 9 cases in NSARP group and 6 patients in ASARP group out of 12 cases had normal bowel movements of once or twice a day.