Browsing by Author "Vijayendra Kumar"

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A child presented with bilateral congenital constriction ring in lower extremity: A case report
(2009) Richa Jaiman; Ajay N. Gangopadhyay; Dinesh K. Gupta; Punit Srivastava; Vijay D. Upadhyaya; Shiv P. Sharma; Vijayendra Kumar
Introduction: The congenital constriction ring of lower extremity is very uncommon and rare condition. The actual incidence in general population is not known. In English literature, very few cases are reported time to time as congenital constriction band syndrome associated with musculoskeletal disorder like congenital talipes equino varus. The lesion can involve skin only or goes to deeper structure up to bone, which can lead to gangrene of foot or auto amputation. Case presentation: We are presenting a case of bilateral congenital constriction ring in lower limb who presented at age of 4 year without any other associated congenital anomaly, simply managed by Z-plasty, which improves quality of life after physiotherapy. Conclusion: Congenital constriction ring of lower limb is extremely rare condition in children. Early diagnosis and management is mandatory, either in single stage or by stage procedure, to prevent auto-amputation of limb and to improve quality of life on feet. © 2009 Jaiman et al.; licensee Cases Network Ltd.
Anterior intratumoural chemotherapy: A newer modality of treatment in advanced solid tumours in children
(Elsevier (Singapore) Pte Ltd, 2008) A.N. Gangopadhyay; Rahi Rajeev; S.P. Sharma; Vijai D. Upadhyaya; N.C. Arya; Vijayendra Kumar; S.C. Gopal
OBJECTIVE: Advanced and inoperable solid tumours in children have high mortality despite aggressive multimodal treatment. Intravenous chemotherapy is abandoned at times because of systemic toxicity. This study investigated intratumoural chemotherapy and compared it with intravenous chemotherapy. METHODS: Forty children with advanced inoperable solid tumours (Wilms' tumour and neuroblastoma) were randomly allocated into two groups of 20. Group A was given intratumoural chemotherapy and group B was given intravenous chemotherapy. Both groups were compared for reduction in tumour size and volume, tumour resectability, histopathological changes and drug side effects. RESULTS: Intratumoural chemotherapy was superior to intravenous chemotherapy in terms of reducing tumour size and volume (63% in group A vs. 22% in group B). The resectability was 70% in the intratumoural group compared with 40% in the intravenous group. The overall good histopathological response was 71% in group A as opposed to 0% in group B. Moreover, the incidence and severity of drug side effects and morbidity were less with intratumoural chemotherapy. Mortality was also low in group A (5%) compared to group B (20%). CONCLUSION: Intratumoural chemotherapy can be offered as an effective and safe alternative treatment modality for advanced and inoperable Wilms' tumour and neuroblastoma. [Asian J Surg 2008; 31(4):225-9] © 2008 Elsevier.
Atresia of ileocecal junction, ileocecal valve: Rare variants of bowel atresia
(2009) Punit Srivastava; A.N. Gangopadhyay; D.K. Gupta; S.P. Sharma; Vijay D. Upadhyaya; Vijayendra Kumar; Richa Jaiman
Atresia of ileocecal junction and isolated atresia of ileocecal valve are rare types of intestinal atresia with very few reports in literature. We report two such cases. Radiology showed dilated ileal segment and distal micro colon in both the cases. At laparotomy there was atresia of ileocecal junction in the first case and isolated ileocaecal valve atresia with normal ileocecal junction in the other case. Both the babies were managed by ileocolic resection with an end to end anastomosis. The prognosis of ileocecal atresias is satisfactory.
Clinical spectrum of neural tube defects with special reference to karyotyping study
(2012) Vijayendra Kumar; Anutosh Singh; Shiv Prasad Sharma; Arvind Srivastava; Ajit Saxena; Ajay Narayan Gangopadhyay
Background: Neural tube defects are common congenital malformations of the central nervous system. Despite years of intensive epidemiological, clinical, and experimental research, the exact etiology of NTD remains rather complex and poorly understood. The present study attempted to look into the association of occurrence of NTD with reference to folic acid levels, along with karyotyping status. Materials and Methods: Detailed history was taken with emphasis on age of the baby and mother, parity, antenatal folic acid intake. Five milliliters of blood was drawn from all the babies and their mothers and divided equally in preheparinized vials (for karyotyping) and plain vials (for folic acid estimation). The total duration was 2 years. Results: The total number (n) in the study group was 75. The folic acid level was less in affected babies and their mother when compared to matched controls. Chromosomal defect was observed in nine of the 75 patients. Karyotyping defects were higher in children born to mothers of the age group 31-40 years and when their birth order was second. Conclusion: Folic acid supplementation needs to be continued to prevent the occurrence of NTD, and the perinatal identification of NTD should alert one to the possibility of chromosomal abnormalities and prompt a thorough cytogenetic investigation and genetic counseling.
Clinico-immunological response to intratumoral versus intravenous neoadjuvant chemotherapy in advanced pediatric solid malignancies
(Georg Thieme Verlag, 2013) Vijayendra Kumar; Nandini Ramaswami; Anand Pandey; Ram Chandra Shukla; Maloy Ranjan Sen; Shiv Prasad Sharma; Dinesh Kumar Gupta; Ajay Narayan Gangopadhyay
Background: There is minimal literature on the use of intralesional chemotherapy in the pediatric age group. We undertook this present study to evaluate the two modalities (intratumoral and intravenous) of giving chemotherapy in terms of toxicity of chemotherapy, hematological parameters, efficacy of chemotherapy in reduction in volume of the tumor as well as resectability of tumor with special emphasis on immunological parameters. Materials and Methods: Advanced cases of Wilms′ tumor and Neuroblastoma were included in the study. Intratumoral chemotherapy was given through 25 G spinal needle under aseptic precautions and ultrasound guidance in the same dose as in systemic chemotherapy. Intravenous group was given chemotherapy in the usual way. Reassessment was carried out after every course of chemotherapy. Results: Group A included 16 cases of Wilms′ tumor and 6 cases of neuroblastoma. In group B, there were 14 cases of Wilms′ tumor and 8 of neuroblastoma. Vomiting, diarrhea, mucositis, and thrombophlebitis were more common in the intravenous group (P<0.05). The fall in Immunoglobulin A, Immunogloblulin G, Immunoglobulin M, and T-cell rosetting was more common in the intravenous group (P<0.05). Seventy percent of patients had completely resectable tumor at the end of 6 doses of intratumoral chemotherapy as compared to 50% resectability in the intravenous group (P<0.05). Conclusion: Intratumoral chemotherapy, besides causing less of the adverse effects and increasing the resecability rate, also causes less suppression of the immune system. This may be offered as an alternative safe and effective modality of treatment for advanced solid tumors.
Conservative management of ulcerated haemangioma - Twenty years experience
(2009) Anand Pandey; Ajay Narayan Gangopadhyay; Shiv Prasad Sharma; Vijayendra Kumar; Saroj Chooramani Gopal; Dinesh Kumar Gupta
Ulceration is the most common complication of haemangioma and occurs in 5-15% of cases. The present study was carried out to evaluate the clinical features of ulcerated haemangioma and efficacy of the management protocol adopted by us over a period of 20 years. All patients with ulcerated haemangioma were evaluated on the basis of age at presentation, sex, rural or urban distribution and site of haemangioma. Treatment included application of topical antibiotic and systemic antibiotic and analgesic for pain. The total number of patients was 608. The male to female ratio was 1: 2·28. The rural:urban distribution was 2·43:1. The most common site of involvement was head and neck. Mean age of patients was 5·60 ± 2·44 months. Mean size of haemangioma and ulceration was 47·30 ± 20·67 cm2 and 7·49 ± 4·52 cm2, respectively. The mean time for ulcer healing was 40·06 ± 19·41 days. Ulcer size of more than 10 cm2 took more time to heal. Response to treatment was satisfactory. Ulcerated haemangioma usually occurs before completion of 1 year of age; hence, every patient with haemangioma needs careful attention. Adequate treatment and regular follow up brings satisfactory response in the patients. © 2009 Blackwell Publishing Ltd and Medicalhelplines.com Inc.
Conservative treatment for round worm intestinal obstruction
(2007) A.N. Gangopadhyay; Vijai D. Upadhyaya; D.K. Gupta; S.P. Sharma; Vijayendra Kumar
Objective. The ascariasis is one of the most cosmopolitan intestinal parasite infections and it can be in inhospitable regions inhabited by human being, but its biggest prevalence is observed in the tropical and subtropical areas. Intestinal obstruction has been estimated to occur in 2 per 1000 ascaris-infected children per year. We are presenting a study emphasizing the conservative treatment for complete intestinal obstruction due to roundworms without sign and symptom of peritonitis and perforation. Methods. A total of 22 patients of roundworm obstruction partial or complete without signs of and symptoms of peritonitis were admitted in the Department of Pediatric Surgery IMS, BHU Varanasi India in the period form 2003 - 2005. Patients were put nil by mouth, intravenous fluid, antibiotics, piperazine salt through nasogastric tube and glycerine + liquid paraffin emulsion enemas and were evaluated for duration of hospital stay, rate of conversion to surgical treatment and complications. Results. 19 (86%) patients were treated successfully with conservative line of management. Only 3 patients required surgical intervention. No mortality, complication and mean hospital stay was 4.1 days (range 4 - 5 days). Conclusion. Round worm intestinal obstruction can be effectively treated by conservative line of management. © 2007 Dr. K C Chaudhuri Foundation.
Evaluation of topical steroids in the treatment of superficial hemangioma
(Pulse Marketing and Communications LLC, 2010) Anand Pandey; Ajay N. Gangopadhyay; Shiv P. Sharma; Vijayendra Kumar; Dinesh K. Gupta; S. Chooramani Gopal
Infantile hemangioma is a common disease. Steroids have been used for its treatment; however, intralesional steroids cause pain and other problems. A treatment modality that can avoid these problems is desirable. The authors evaluated the role of topical steroids as an alternative to intralesional steroids in the treatment of superficial hemangioma. Inclusion criteria were <2 superficial type of hemangiomas <5 cm. The topical steroid mometasone furoate was applied twice daily. Intralesional triamcinolone acetonide was injected at monthly intervals using a 24-gauge needle at doses of 1 to 2 mg/kg. Forty-five (86.5%) patients responded to treatment with the topical steroids, of which 50% had excellent and 36.5% had good response. In the intralesional group, the response rate was 95.7%, of which 63.8% had excellent and 31.9% had good response. Complications in the topical steroid group were mild itching and irritation (19.2%) and hypopigmentation (7.6%). Complications in the intralesional group were pain (100%), bleeding (17%), infection (17%), cutaneous atrophy (8.5%), cushingoid facies (2.1%), and growth retardation (2.1%). Topical steroids are a reasonably good alternative to intralesional steroids as an initial choice for treating superficial hemangioma. © 2010 Pulse Marketing & Communications, LLC. All rights reserved.
Functional evaluation of mid and distal penile hypospadias surgery with special reference to uroflowmetry
(S. Karger AG, 2011) Anand Pandey; Ajay N. Gangopadhyay; Vijayendra Kumar; Shiv P. Sharma; Dinesh K. Gupta; Saroj C. Gopal
Background: To assess two different operative techniques in hypospadias with special emphasis on urinary flow with the help of uroflowmetry. Material and Methods: In this prospective study, all patients underwent either Snodgrass or Mathieu urethroplasty. Preoperative uroflowmetry was done in every patient. Postoperative uroflowmetry was done 2 weeks after stitch removal only in those patients who were not having urethral fistula. Postoperative dilation was done only in those patients who had decreased urinary flow as compared to preoperative values. Results: Fifty patients were included in this 2-year study. Uroflowmetry was performed in 37 patients. Twenty-two patients underwent Snodgrass urethroplasty and the other 15 had Mathieu urethroplasty. Pre- and postoperative Qmax values were 6.57 ± 2.67 and 7.36 ± 3.90 ml/s, respectively. Qavg values were 4.16 ± 1.87 and 4.52 ± 2.50 ml/s, respectively. Although statistically insignificant, the Snodgrass technique appeared to be relatively better than Mathieu's technique. Conclusion: Uroflowmetry can predict the need for dilation in hypospadias. The Snodgrass technique appears to be functionally better than Mathieu's technique. With avoidance of unnecessary trauma due to dilation, the cooperation of pediatric patients can be achieved. © 2011 S. Karger AG, Basel.
Gall bladder perforation as a complication of typhoid fever
(Medknow Publications and Media Pvt. Ltd, 2008) Anand Pandey; Ajay N. Gangopadhyay; Vijayendra Kumar
[No abstract available]
Giant meconium hydrocele: A rare presentation of antenatal gastrointestinal perforation
(2011) Punit Srivastava; Ajay N. Gangopadhyay; Dinesh K. Gupta; Vijayendra Kumar; Shiv P. Sharma; Vijai D. Upadhyaya; Richa Jaiman
[No abstract available]
Juvenile polyposis syndrome
(2008) Vijai Upadhyaya; A. Gangopadhyaya; S. Sharma; S. Gopal; D. Gupta; Vijayendra Kumar
Aim: Report of a series of 12 cases of juvenile polyposis coli. Methods: The study period was from 1995 to 2005. All the patients were treated by total colectomy with rectal mucosectomy and endorectal ileoanal pullthrough with or without ileal pouch formation. Covering ileostomy was avoided in all the cases. Time taken for the surgery, postoperative complications and continence were documented. Results: The mean operating time was 4.2 h (range: 4-5 h). The mean duration of hospital stay was 16.3 days (range: 15-18 days). The most common postoperative complication was pouchitis and perianal excoriation. Initially, all the patients were passing stools at an interval of 2 h, and after 3 weeks, the frequency has reduced to 6-8 stools per day. In the follow-up after 3 months, the frequency was 3-5 per day with minimal soiling. Conclusions: Single-stage total colectomy with rectal mucosectomy and endorectal ileoanal pull-through without covering ileostomy and pouch formation is a safe and definitive treatment for juvenile polyposis coli if the patient selection is appropriate.
Long-term follow up of mesenchymal hamartoma of liver-single center study
(2011) Anand Pandey; Ajay N. Gangopadhyay; Shiv P. Sharma; Vijayendra Kumar; Dinesh K. Gupta; Saroj C. Gopal; Shashikant C. Patne
Background/Aim: Mesenchymal hamartoma of liver (MHL) is a rare liver tumor of childhood. About 200 cases have been reported till now. Most of the work on MHL is limited to case reports and there are not many long term follow-up studies. We present our 20 years of experience with this uncommon entity. This study aims to highlight clinical features, diagnosis and treatment of MHL. Materials and Methods: All patients with a diagnosis of MHL in last 20 years were included in this retrospective study. The patients were evaluated clinically, radiologically and pathologically. Results : The total number of patients with a diagnosis of MHL was nine. Mean age of the patients was 19.89 ± 2.75 months. Right lobe was involved in eight patients. The prominent clinical features were distension of abdomen and anorexia. Surgical options used were hepatic lobectomy, wedge resection and enucleation. Histopathology of the specimens showed cysts of variable size with normal hepatocytes, bile ducts and connective tissue stroma. Overall mortality was one (11.11%). Conclusion: MHL is a benign tumor that can present with various clinical features. It should be differentiated carefully from other liver masses especially malignant ones. The diagnosis can be made with the help of radiology and histopathology. Adequate resection is curative in most of the cases and long-term follow up is satisfactory.
Minimizing the postoperative complications of severe hypospadias using a simple technique
(2012) Vijayendra Kumar; Ram Avtar Rathore; Ajay Narayan Gangopadhyay; Dinesh Kumar Gupta; Shiv Prasad Sharma
Background The aim of this study was to decrease complication rates in proximal hypospadias surgery. Methods A simple method of stenting using a polypropylene stent has been developed for the most severe form of hypospadias during the period from January 2008 to January 2011 in the Department of Pediatric Surgery. The total number of patients was 46. The patients were classified into group 1 (n= 23), in which a polypropylene stent was used, and group 2 (n= 23), in which a polypropylene stent was not used. Results In group 1, complications occurred in three patients (13.04%), whereas in group 2 it occurred in 12 patients (52.2%). The difference in the total number of complications between groups was highly significant (< 0.001). In group 1, no patient needed redo surgery, and in group 2 four patients (17.39%) needed redo surgery (< 0.05). All other patients responded to repeated dilatation in the follow-up. Conclusion Although the sample size was small, this simple modification can decrease the complication rate significantly in the most severe form of hypospadias. Ann Pediatr Surg 8:32-34 © 2012 Annals of Pediatric Surgery.
Necrotizing fasciitis in children with special reference to anaerobes
(2009) Anand Pandey; Ajay N. Gangopadhyay; Shiv P. Sharma; Vijayendra Kumar; Vijai D. Upadhyaya
Necrotizing fasciitis is a rapidly progressive and potentially fatal infection. It is a rare infectious entity that posses challenging diagnostic and therapeutic management for a pediatric surgeon. Anaerobic bacteria are the predominant flora in the normal human skin and mucous membranes and are, therefore, a common cause of endogenous infections. Infections due to anaerobes are often polymicrobial, and include aerobic and facultative bacteria. Some predisposing conditions are found to be associated with the recovery of certain anaerobe organisms. This review aims to give a better understanding of the etiology, pathology, diagnosis and treatment of necrotizing fasciitis in children with special emphasis on the role of anaerobes. © 2009 IOS Press. All rights reserved.
Neonatal necrotising fasciitis - Varanasi experience
(2008) Ajay Narayan Gangopadhyay; Anand Pandey; Vijay Dutt Upadhyay; Shiv Prasad Sharma; Dinesh Kumar Gupta; Vijayendra Kumar
Neonatal necrotising fasciitis (NNF) is a rare and fatal disorder. Successful outcome depends on timely intervention. This paper presents single-centre experience of presentation, management and outcome of the condition. Fifteen patients of NNF were managed during the study period of 5 years. Parameters studied were age, sex, site of involvement and treatment. Treatment included intravenous (i.v.) antibiotics and conservative surgery. Age of presentation was 10-28 days. Male to female ratio was 2:1. Neck and scalp were the commonest site (53.3%). Culture reports were unimicrobial in 66% with predominance of Staphylococcus species. Predisposing factors included rural environment (100%), malnourishment (60%), boils (40%) and scratch injury (13%). Forty per cent had idiopathic NNF. Wound healing was by secondary intention in 46.6% and skin grafting in 53.3%. Overall survival was 80%, while the premature had poorer outcome. NNF is a serious disorder. Early treatment with i.v. antibiotics and supportive measures followed by debridement improves survival. © 2007 Blackwell Publishing Ltd and Medicalhelplines.com Inc.
Pediatric surgery during coronavirus disease lockdown: Multicenter experience from North India
(Wolters Kluwer Medknow Publications, 2020) Sandip Kumar Rahul; Manish Kumar Gupta; Digamber Chaubey; Deepak Kumar; Rupesh Keshri; Vijayendra Kumar; Vijai Datta Upadhyaya
Background: Coronavirus disease Pandemic has affected the health-care delivery at all institutions worldwide. Analysis of multi-institutional data would reflect the impact and challenges of this pandemic in managing pediatric surgical cases. To assess the impact of lockdown due to coronavirus disease 2019 (COVID-19) on the pediatric surgical cases operated at four tertiary care institutions. Materials and Methods: Retrospective data of all patients operated at four tertiary care centers in North India in three different states during the imposition of lockdown due to COVID-19 were collected and compared to the immediate prelockdown period. The impact of following the guidelines for surgery during this period was studied. Results: All the institutions involved in the study showed a significant fall in the number and nature of patients treated during the lockdown period when compared to the prelockdown data. No elective cases were operated; 100 children were operated during this period of which neonates (56%) formed the major group; most of them were cases of congenital anomalies which could not be deferred; solid tumours (3/100) were operated on semi-emergency basis; number of trauma patients fell down drastically (1/100); one patient had bronchoscopic foreign body removal; other patients were operated for different causes of acute abdomen. Several measures in the outpatient, intraoperative, and in-patient care were adopted to lessen the spread of virus to the patient and health-care team. Conclusion: Corona pandemic severely impacted both the number and types of patients operated. Strict adherence to the protocol delayed emergency treatment and increased the cost of definitive management. © 2020 Formosan Journal of Surgery.
Prognosis of congenital tracheoesophageal fistula with esophageal atresia on the basis of gap length
(2007) Vijay D. Upadhyaya; A.N. Gangopadhyaya; D.K. Gupta; S.P. Sharma; Vijayendra Kumar; Anand Pandey; Ashish D. Upadhyaya
Congenital tracheoesophageal fistula (TEF) with esophageal atresia (EA) is not an uncommon disease of newborns. Several classifications have been advocated for predicting the outcomes of these patients but all are physiological and concentrated on associated medical condition that influences survival. We emphasize a new classification on the basis of gap between two esophageal pouches to define the magnitude of surgical problems in the primary repair and correlate them with the outcomes in terms of anastomotic leak, esophageal stricture and mortality, keeping other prognostic factors constant. A total of 50 cases of congenital TEF with EA were included and all underwent primary esophageal anastomosis after the ligation of TEF. The gap between the two pouches was meticulously measured intraoperatively using a vernier caliper before the ligation of TEF, and patients were divided into four groups on the basis of gap length. Group A, where gap length was >3.5 cm (ultralong), group B where gap length was 2.1-3.5 cm (long gap), group C where gap length was >1 cm but not more than 2 cm (intermediate group) and group D, where the gap between two esophageal pouches was 1 cm or less (short gap). The incidence of anastomotic leak was 80, 50, 28, 10.5% and the incidence of esophageal stricture was 100, 75, 22.5, 19% after successful primary repair, respectively, in groups A, B, C and D. The mortality was highest in group A (80%) followed by group B (50%) and 22% in group C and least 15.6% in group D. The incidences of esophageal leak and mortality were found to be statistically significant. This classification which is based on easily measurable criteria provides a useful method to predict morbidity, long-term outcome and mortality of EA with TEF surgery. © 2007 Springer-Verlag.
Role of fibrin glue as a sealant to esophageal anastomosis in cases of congenital esophageal atresia with tracheoesophageal fistula
(2007) Vijai D. Upadhyaya; Saroj C. Gopal; Ajay N. Gangopadhyaya; Dinesh K. Gupta; Shiv Sharma; Ashsish Upadyaya; Vijayendra Kumar; Anand Pandey
Objective: The aim of this study was to characterize a successful approach for the management of infants with long-gap esophageal atresia (EA) with tracheoesophageal fistula (TEF). The goal was to preserve the native esophagus and minimize the incidence of esophageal anastomotic leaks using fibrin glue as a sealant over the esophageal anastomosis. Method: A total of 52 patients were evaluated in this study. Only patients in whom, gap between the two ends of the esophagus was ≥ 2 cm were selected during January 2005 to January 2007. Patients were divided in two groups on the basis of block randomization. Group A comprised the patients in whom fibrin sealant was used as reinforcement on a primary end-to-end esophageal anastomosis; in group B, fibrin glue was not used. The two groups were compared in terms of esophageal anastomotic leak (EL), postoperative esophageal stricture (ES), and mortality. The statistical analysis was done using Fisher's exact test and the chi-squared test. Result: The number of anastomotic leaks in group A (glue group) was about one-fifth that in group B (no glue group). The incidence of ES was almost twice as high in group B as in group A. The mortality rate was almost threefold higher in group B (no-glue group). The higher incidence of EL and ES in group B compared to group A was statistically significant. Conclusion: Thus, fibrin glue when used as an adjunct to esophageal anastomosis for primary repair of long-gap EA with TEF appears safe in the clinical setting and may lower the chances of esophageal leak and anastomosis-site strictures. Hence, it can diminish the mortality and morbidity of these patients. © 2007 Société Internationale de Chirurgie.
Single stage repair of anovestibular fistula in neonate
(2007) Vijay D. Upadhyaya; S.C. Gopal; D.K. Gupta; A.N. Gangopadhyaya; S.P. Sharma; Vijayendra Kumar
Anorectal malformations are one of the most common congenital defects. This study is conducted to evaluate the result of single stage anterior sagittal anorectovaginoplasty (ASARVP) in cases of vestibular anus (AVF) in neonatal age group without thorough gut preparation. All the patients of AVF admitted during 2003-2006 were included in this study. Single stage ASARVP was done in these patients without preparing the bowel in the lithotomy position, the fistula was freed and sufficient length of anorectum was dissected and vagina was separated. Midline incision at the proposed anal site was made, then a plane was dissected between the muscle complex going anteriorly. The mobilized anorectum was pulled to the proposed anal site and proper anoplasty was done. The results were evaluated for duration of surgery, need of bowel preparation, commencement of feed and hospital stay and follow-up (assessment of continence and anal dilatation). A total of 27 patients were included in our study. All patients were less than 1-month-old. Operative time ranges from 50 to 70 min. Bowel preparation was not needed. Per oral feed was started after 48 h in all patients and average duration of hospital stay was 3- 4 days. Postoperative regular anal dilatation was commenced after 1 week of operation. Continence results according to Kelly's method were good in 70%, fair in 21% and poor 9%. Single-stage anorectovaginoplasty in neonates has a good result in cases of AVF and avoids the need of bowel preparation. © 2007 Springer-Verlag.