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Transuterine Fetal Tracheal Occlusion Model in Mice
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Delayed presentation of anorectal malformations.

Shandip Kumar Sinha1, Ravi P Kanojia, Ashish Wakhlu

  • 1Department of Pediatric Surgery, King George Medical University, Lucknow, India.

Journal of Indian Association of Pediatric Surgeons
|December 17, 2009
PubMed
Summary

Delayed management of anorectal malformation (ARM) is common and often caused by incorrect medical advice. Despite delays, surgical outcomes for ARM patients are similar to early presenters, though reoperations lead to poorer results.

Keywords:
Anorectal malformationdelayed presentation

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Area of Science:

  • Pediatric Surgery
  • Congenital Anomalies
  • Surgical Outcomes

Background:

  • Delayed management of anorectal malformation (ARM) is associated with increased surgical and functional complications.
  • Defining and understanding the incidence and causes of delayed ARM presentation is crucial for improving patient care.

Purpose of the Study:

  • To define "delayed presentation of ARM" and determine its incidence and causes.
  • To review patient records to identify factors contributing to delayed ARM presentation and analyze outcomes.

Main Methods:

  • Retrospective review of hospital records for patients meeting the criteria for "delayed presentation of ARM".
  • Data collected included presentation details, associated anomalies, management plans, and follow-up information.

Main Results:

  • 43 patients (21 males, 22 females) met the criteria for delayed ARM presentation between 2003 and 2006.
  • Delayed presenters experienced prolonged issues like constipation and inadequate weight gain.
  • Previous failed perineal surgery correlated with increased functional complications; anterior sagittal anorectoplasty (ASARP) was preferred for low-type ARM in females.

Conclusions:

  • Delayed ARM presentation constitutes a significant patient group in this setting.
  • Management and treatment outcomes for delayed ARM presenters were comparable to early presenters.
  • Incorrect medical advice and inadequate prior treatment were the most common causes of delayed ARM; revision surgeries yielded poorer outcomes.