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

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.