Keywords
imperforated anus
child
children
quality of life
Rectal diseases
Surgery
Surgeons
VACTERL
Surveys and Questionnaires
Rectum / abnormalities
Rectum / surgery
How to Cite
Abstract
Objective: Bowel function in patients post-surgical repair of low forms of anorectal malformations (ARMs) was evaluated. This study aimed to identify predictors of functional outcomes to guide parental counseling and predict quality of life.
Methodology: Patients treated for ARMs at Ghent University Hospital between 2005 and 2015 were retrospectively analyzed. Data included demographics, ARM type, diagnosis timing, operative management, and associated anomalies. Bowel function was assessed using both the Rintala questionnaire filled in by parents, resulting in a bowel function score (BFS), and clinical outcome (CO) as evaluated by the surgeon.
Results: In total, 80 patients were analyzed, of which 59 girls (74%), with a median follow-up age of 7.7 years. Early diagnosis (within the first week of life) occurred in 61%. The most common ARM type was rectoperineal fistula (87.5%). Associated anomalies were present in 40% of patients, with 12.5% having VACTERL association. Normal BFS (≥18/20) was achieved in 47.5% of patients, with 54% having excellent CO. There was a significant correlation between BFS and CO (p<0.001). Rectal trimming was associated with lower BFS (p=0.003). Presence of a developmental disorder significantly impaired BFS (p=0.013). No significant differences were observed based on diagnosis timing or surgical approach.
Conclusion: Half of the patients achieved excellent BFS and CO at mid-long follow-up, with significant negative impact of rectal trimming during surgery and presence of a developmental disorder later in life. No significant impact of timing of diagnosis or surgery was seen. Rintala questionnaire correlated well with CO, suggesting being useful in follow-up.