Bowel function in children with low-type anorectal malformation after surgical repair
Abstract
Aim The aim of this study was to search for any association between demographic, clinical, and therapeutic characteristics of patients with a low-type anorectal malformation (ARM) and their long-term bowel function. Methods In this retrospective study, 108 patients were contacted, of which 80 patients (74%) were included. Demographic, clinical, and therapeutic information was obtained from the patients’ medical records. The standardized Rintala questionnaire (resulting in a bowel function score (BFS)) was used to evaluate bowel function. Data was analyzed with SPSS 26 (significance level = 0.050). Results 80 patients (21 boys (26.3%)) were included, 70 (87.5%) presented with a rectoperineal fistula, 9 (11.3%) with a rectovestibular fistula, and 1 (1.2%) with anus imperforatus. The Mann-Whitney U test showed a significant negative impact of trimming of the anorectum (p = 0.003) and the presence of a developmental disorder (p = 0.013) on bowel function. Patients with sacral/spinal anomalies also showed a negative trend on the BFS score (p = 0.086), but was not significant probably due to a small patient group. The other characteristics (sex, prematurity, time of diagnosis, preoperative interventions, dehiscence, time of operation, and ARM type) were not significant. Multiple linear regression confirmed these results. Conclusions Trimming and the presence of a developmental disorder have a significant negative impact on the bowel function of patients with a low-type ARM. A…
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