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Anorectal malformation without fistula: a defect with unique characteristics
Andrea Bischoff1, Jason Frischer, Belinda H Dickie
1Division of Pediatric Surgery, Colorectal Center for Children, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 2023, Cincinnati, OH, 45229, USA, andrea.bischoff@cchmc.org.
Pediatric Surgery International
|June 28, 2014
Summary
Anorectal malformation (ARM) without fistula is a distinct condition. Patients, including those with Trisomy 21, show good functional prognosis for bowel control and low rates of urinary defects.
Area of Science:
- Pediatric surgery
- Congenital anomalies
- Genetics
Background:
- Anorectal malformations (ARMs) without fistula represent a small percentage of all ARM cases.
- The association between ARM without fistula and Trisomy 21 is noted, with limited prior literature focusing on this specific subgroup.
- This study aims to review the unique characteristics and therapeutic implications of ARM without fistula.
Purpose of the Study:
- To analyze the demographic, anatomic, and prognostic factors of ARM without fistula.
- To evaluate the surgical outcomes and long-term functional prognosis in patients with ARM without fistula.
- To compare outcomes in patients with and without Trisomy 21.
Main Methods:
- Retrospective review of 92 patients with ARM without fistula from September 1980 to March 2014.
- Data collection included demographic, anatomic, and prognostic factors, as well as outcome variables.
- Comparison with other types of ARMs was performed.
Main Results:
- Out of 2,189 ARM cases, 92 (4%) had no fistula. 40% of these patients had Trisomy 21.
- Surgical repair was successful in most cases, with a low incidence of urethral injury.
- Long-term bowel control was achieved in 61% of patients with Trisomy 21 and 85% without Trisomy 21. Urinary control was universal in patients without Trisomy 21.
Conclusions:
- Anorectal malformation without fistula is a unique entity with specific surgical challenges, particularly the common wall between the rectum and urethra/vagina.
- The condition demonstrates a favorable functional prognosis for bowel control, even in the presence of Trisomy 21.
- Associated urologic defects are infrequent in patients with ARM without fistula.
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