Outcome of children operated for congenital anorectal malformations: A prospective single center study

Anorectal malformations (ARM) occur in approximately 1 in 5000 live births and affects males and females almost equally. Operative correction of pediatric ARM is of potential clinical interest; however, long-term outcome of patients in respect to probable complications requires precise follow up and surveillance. The aim of the present study was to assess the outcomes of children undergoing surgical correction of ARMs.
In a prospective follow-up study, we wanted to assess occurrences of incontinence, constipation, soiling, abdominal distension, diarrhea, stenosis, dilated sphincter and failure to thrive (FTT) in ARM patients. In addition, management of these conditions has been discussed. Reoperations have also been reviewed. The primary outcome of the study was determination of occurrence of incontinence at follow-up visits. Secondary outcomes were occurrence of constipation, anal stenosis, soiling, abdominal distension, dilated sphincter, diarrhea and FTT at follow-up visits. In addition, the decision of research team on patients at follow-up visits was considered as secondary outcomes.
Two hundred ninety patients were studied. Of the study patients, 174 children (60.4%) were boys and 114 children (39.6%) were girls. Mean age of boys was 4.8 ± 2.0 years of age and mean age of girls was 5.0 ± 2.0 years of age. The mean follow-up period of patients was 39.5 ± 29.1 months. During the study follow-up period, 63 patients (21.7%) had complications. The most common complication was constipation. It was present in 21 patients (33.3%). Soiling, incontinence, dilated sphincter, FTT, stenosis, abdominal distension and diarrhea were present in 21 (33.3%), 11 (17.5%), 9 (14.3%), 6 (9.5%), 6 (9.5%), 5 (7.9%), 3 (4.8%) and 2 (3.3%) patients respectively.
We found that the commonest complications following ARM surgery are constipation, soiling, incontinence, dilated sphincter, FTT, stenosis, distension and diarrhea. The overall complication rate was 21.7%. 7.2 % and 3.1% of study population experienced constipation and incontinency respectively. 3.1% of study population required reoperation. We revealed that outcome of surgical correction of ARMs is considerably good and complication rates are acceptable. Continence rate was acceptable.