[Morphological criteria for surgical treatment of anorectal malformations in children].

Objective: To improve treatment outcomes in patients with anorectal malformations via research of morphological criteria and differentiated approach to surgical correction.
Material and Methods: There were 37 children with various types of anorectal malformations for the period 2000-2019. We analyzed morphological features of atretic rectum wall, fistula, anastomosis with adjacent organs and skin of the perineum.
Results: Morphological research of anorectal malformations made it possible to differentiate treatment strategy and explain the causes of unsatisfactory results after perineal and abdominal-perineal proctoplasty. Incidence and severity of complications, as well as early disability were reduced that significantly improved postoperative quality of life.
Conclusion: According to the morphological criteria, deeper mobilization of atretic rectum within at least 2.5-3 cm of the rectal «cone» with intact muscular wall is necessary. This approach was valuable to ensure adequate closure function of the rectum, prevent anal incontinence and restore normal appearance of the perineum. These achievements contributed to decrease in the incidence of admissions, redo surgeries and improvement of social adaptation in children.