Congenital Pouch Colon: A Comparative Study between Two Modalities of Management

BACKGROUND: Congenital pouch colon (CPC) is an unusual anomaly with an unique geographical distribution. The aim of this study was to find out the incidence of CPC among anorectal malformation (ARM) cases in our institute and to compare the outcome between conventional three-staged surgery versus two-staged management approach. MATERIALS AND METHODS: This study was conducted in the department of pediatric surgery over a period of 7 years from 1(st) April 2013 to 31(st) March 2020. RESULTS: Out of 754 cases of ARMs, 43 cases of CPC were detected. The incidence of pouch colon among patients with high ARMs was found to be 7.6% with a male predominance (M:F = 4.4:1). The anomaly was diagnosed in 72% of our patients preoperatively and Type IV variety was the most common intra-operative finding. The survival after initial hospitalisation was 82% and 88% in three-stage and two-stage surgical procedures, respectively. However, the final clinical outcome after the completion of all stages of surgery and follow-up was better in two-staged approach (54% vs. 47%). CONCLUSION: Although, CPC is a rare anomaly, the incidence in our institute is 7.6% among high ARM cases. As compared to conventional three-staged surgery, the two-staged management approach has the advantage of better survival and decreased morbidity.