Primary single stage repair of newborn babies with pouch colon (anorectal malformation) in a tertiary setup

Background:  The standard procedure in the management of pouch colon is the staged procedure (SP), which has well-known disadvantages. We believe that staged procedure is unnecessary and single-stage procedure (SSP) can be done in the congenital pouch colon cases. Methods: Patients with pouch colon who underwent SSP (90 cases from 2008 to 2013) and SP (100 cases from 2003 to 2008), 65 and 55 of whom, respectively, were in regular follow-up for more than 3 years, were evaluated. Results:  In SSP, male/female ratio was 87:3; in SP-94:6. Mean age of patient in SSP was 3.7 days and in SP 15 months. The distribution of cases into types I, II, III, and IV was 7, 16, 18, and 24 in SSP, and 6, 14, 15, and 20 in SP, respectively. The ratio of PSSP/SP for partial pouch colon (I and II) was 23:20 and for complete pouch colon (III and IV) was 42:35. The ratio of SSP/SP in terms of continence, mortality, and cost was 81:60, 17:53, and 1:6, respectively. Conclusions:  Primary single-stage procedure gives better continence and cosmesis, with low morbidity and mortality at a low cost, and hence is recommended.