1. The long-term post-surgical outcome of intermediate anorectal malformation in our department.
- Author
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Tamura R, Kido M, Nakamura K, Kuwahara T, Hirotani T, Yasui Y, and Okajima H
- Subjects
- Humans, Male, Female, Treatment Outcome, Infant, Follow-Up Studies, Child, Preschool, Postoperative Complications, Anal Canal surgery, Anal Canal abnormalities, Plastic Surgery Procedures methods, Rectum surgery, Rectum abnormalities, Child, Retrospective Studies, Fecal Incontinence etiology, Fecal Incontinence surgery, Adolescent, Laparoscopy methods, Anorectal Malformations surgery
- Abstract
Background: Posterior sagittal anorectoplasty and laparoscopic-assisted anorectal pull-through are preferred for anorectal malformation (ARM) today, while careful pull-through procedures with sacroperineal approach yield excellent outcomes. This study focuses on a pull-through procedure emphasizing continence mechanism preservation and compares outcomes with historical studies with various procedures., Methods: Bowel function of patients with intermediate ARM followed up for over 10 years post-surgically was assessed. Data collected included ARM type with the Krickenbeck classification, comorbidities, complications, post-surgical examinations, follow-up, and bowel function at the latest clinic visit. The literature review collected original articles including more than 10 post-anorectoplasty cases which were followed for over 10 years., Results: Eleven cases were identified, with a median age at anorectoplasty and follow-up length of 6.9 months and 14.4 years. Two fistula recurrences required surgical treatment. Long-term incontinence and constipation were observed in 9% and 45% of the cohort, respectively. Good rectal angulation and a positive rectoanal inhibitory reflex were confirmed in most cases examined. A literature review identified eight studies with various outcome-measuring instruments., Conclusion: Outcomes of the introduced pull-through procedure were favorable, while the literature review highlights the variation in outcomes of various anorectoplasty., Evidence Level: Level IV., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2024
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