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Constipation is a major complication after posterior sagittal anorectoplasty for anorectal malformations in children

Ching-Fang Huang1, Hung-Chang Lee, Chun-Yan Yeung

  • 1Department of Pediatrics, Mackay Memorial Hospital, Taipei City, Taiwan.

Pediatrics and Neonatology
|September 12, 2012
PubMed

Insights

Constipation is the most frequent complication following posterior sagittal anorectoplasty for anorectal malformation (ARM). Fecal incontinence is significantly less common in children after this surgery.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Colorectal Surgery

Background:

  • Anorectal malformation (ARM) requires surgical correction, often via posterior sagittal anorectoplasty (PSARP).
  • Long-term functional outcomes, particularly bowel function, are critical after PSARP.
  • Assessing late complications like constipation and fecal incontinence is essential for patient management.

Purpose of the Study:

  • To determine the incidence of constipation and fecal incontinence as late complications after PSARP in ARM patients.
  • To compare the frequency of these two major bowel dysfunctions post-surgery.

Main Methods:

  • Retrospective study of 188 children with ARM who underwent PSARP.
  • Analysis of medical records focusing on bowel habits and medication history.
  • Utilized the Symptom Severity (SS) scoring system to evaluate bowel habit changes.

Main Results:

  • Constipation was the most prevalent late complication, affecting 64.5% of low-type ARM and 78.6% of high-type ARM patients.
  • Fecal incontinence occurred less frequently (4.7% in low-type ARM, 3.9% in high-type ARM).
  • No significant difference in mean SS scores was observed between low-type and high-type ARM groups.

Conclusions:

  • Constipation is the predominant late sequela following surgical correction of ARM.
  • PSARP is associated with a higher incidence of constipation compared to fecal incontinence.
  • Ongoing monitoring for constipation is crucial in the long-term management of pediatric ARM patients.
Abstract

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