Abstract
Background/aims: Outcomes of anorectal malformations have greatly improved but many children still experience some form of urinary or fecal incontinence despite optimal management. The aim is to evaluate the functional outcome in infants with anorectal malformation for different surgical procedure including traditional and recent operations and outcome for different type of anorectal malformation. Subjects and Methods : An analytical study include 28 cases of anorectal malformation (16 males and 12 females ) operated by different technique in Erbil city during 2010 - 2016. Cases of cloaca and early deaths were excluded from the study. Results : In male Rectoperineal fistula (25% ) and in female Rectovestibular fistula (25% ) were the most common anomalies. the most common procedure were primary anorectoplasty for perineal fistula in both male and female infants in 10 cases ( 35.71% ) followed by transfistula anorectoplasty for rectovaginal fistula in 7 cases (25%) and PSARP for rectobladder neck and urethral fistula for male infants in 6 cases. The most common functional complication was constipation in 2 (7.15%) cases and only one case (3.57%) developed fecal incontinence . 89.29 percent of the patients had voluntary bowel movements and were totally continent. Conclusion : Despite significant developments in the understanding of the pathophysiology and surgical techniques, the results of surgery of ARM remain far from perfect. An optimal operation restores normal anatomy and preserves all potential sphincter structures. Functional complications, especially treatable ones, such as constipation, should be detected and treated early to achieve an optimal outcome.
Highlights
With an anorectal malformations (ARM), several problems can occur, the anal passage may be narrow, may be covered with a membrane, the rectum may connect to part of the urinary tract or the reproductive system .The pelvic muscles, nerves, spine all often have a similar degree of malformation. (1)10.33762/mjbu.2020.128515.1039Despite optimal surgical management, many children still experience effects in the form of urinary or fecal incontinence, no adequate repair for poorly developed muscles or nerves has been developed
(5) So the aim of this study was to evaluate the postoperative functional outcome in infants with anorectal malformation for different surgical procedure used for treatment of these anomalies
For all cases of perineal fistula minimum PSARP was done and cases of anal stenosis were treated by dilatation alone
Summary
Many children still experience effects in the form of urinary or fecal incontinence, no adequate repair for poorly developed muscles or nerves has been developed. The most common post operative problem is frequent bowel motion and uncontrollable soiling may continue for a long period of time, often for years. This is the case with operations where the terminal rectum is resected. The outcomes of anorectal malformations (ARM) have greatly improved during the last decades, but many children still experience effects in the form of urinary or fecal incontinence despite optimal surgical management. Functional complications, especially treatable ones, such as constipation, should be detected and treated early to achieve an optimal outcome
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