Sphincter preserving anorectoplasty (SPARP) with anterior approach: A revisited and modified technique in the treatment of anorectal malformations

jpedsurg.org

Surgical management of anorectal malformations (ARM) such as rectoperineal and rectovestibular fistulas frequently involves posterior sagittal anorectoplasty (PSARP). Despite good outcomes, PSARP risks sphincter transection, perineal body dehiscence, and stenosis. We revisited and modified the sphincter-preserving anorectoplasty (SPARP) technique with an anterior approach, hypothesizing that avoiding midline sphincter incision would improve outcomes.

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Article · Jul 2025 · 1 min read

In brief

This article describes a modified sphincter-preserving anorectoplasty (SPARP) using an anterior approach for treating anorectal malformations with rectoperineal and rectovestibular fistulas. The technique aims to reduce complications associated with traditional PSARP, including sphincter damage, dehiscence, and stenosis, by avoiding midline sphincter incision.

PSARP for ARM carries risks of sphincter transection, perineal body dehiscence, and stenosis despite good outcomes
SPARP with anterior approach avoids midline sphincter incision, potentially reducing sphincter-related complications
Modified SPARP technique offers sphincter preservation alternative for rectoperineal and rectovestibular fistulas
Anterior approach in SPARP may improve surgical outcomes by preserving sphincter complex integrity

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