424098

Complication after Congenital Anorectal Malformation Repair

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Last updated: 27 Apr 2025

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Abstract

Anorectal malformation (ARM) is a spectrum of structural congenital anomaly involving the anorectum and variable segments of the urogenital system in boys and girls. They occur in approximately 1 in 5000 live births. The surgical approach for repairing these defects changed dramatically in 1980 with the introduction of the posterior sagittal approach. Despite all efforts done to reach proper management of ARM, short- and long-term complications still continue to impact the patients' quality of life. The main concerns for the surgeon in correcting these anomalies are bowel control, urinary control that can't be achieved even with an excellent anatomic repair, due to mainly associated problems such as a poorly developed sacrum, deficient nerve supply, and spinal cord anomalies, there are many cases had non optimal results. For these patients, an effective bowel management program, including enema and dietary restrictions has been advised to improve their quality of life. The aim of the study to evaluate complications post anorectal malformation repair for variety of cases of anorectal malformation.To assess the relation between  these complication, type of anomaly, technical repair, times of procedure and surgeon experience, to estimate possible etiology and proper management. Observational, descriptive, combined retrospective and prospective study on 20 patients presented by complications post ARM repair, included both genders, aged between 1 month and 12 years.  Patients were subjected to detailed history taking, proper clinical examination, Laboratory investigations, Radiological investigations included ( pelvi-abdominal us, pelvi-abdominal X-ray, lumbo sacral X-ray, contrast enema, distal loopogram,  ascending cystourethrogram, voiding cystourethrogram,  anorectal manometry and  hegar size. This study show that complications post ARM repair are various such as constipation which is most common one that occur mainly in the low anomaly and indicate good prognosis, anal mislocation, anal stricture, infection and fecal incontinence.  Despite the extensive progress attained in the management of ARMs, short- and long-term complications still continue to impact the patients' quality of life. Some of the complications are related with surgery, while the type and severity of malformations and associated anomalies play a central role in the long-term outcome.

DOI

10.21608/aujv.2024.424098

Keywords

Anorectal malformation, Posterior sagittal anorectoplasty (PSARP), constipation, Fecal incontinence

Volume

6

Article Issue

3

Related Issue

51517

Issue Date

2024-09-01

Receive Date

2025-04-23

Publish Date

2024-09-01

Page Start

113

Page End

125

Print ISSN

3009-7819

Online ISSN

3009-6685

Link

https://aujv.journals.ekb.eg/article_424098.html

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http://journals.ekb.eg?_action=service&article_code=424098

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424,098

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Original Article

Type Code

1,261

Publication Type

Journal

Publication Title

Al-Azhar University Journal of Medical and Virus Researches and Studies

Publication Link

https://aujv.journals.ekb.eg/

MainTitle

Complication after Congenital Anorectal Malformation Repair

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Article

Created At

27 Apr 2025