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Updated: Dec 28, 2025

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General complications after surgery for anorectal malformations.

Emre Divarci1, Orkan Ergun2

  • 1Department of Pediatric Surgery, Faculty of Medicine, Ege University, Izmir, Turkey.

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Summary

Posterior sagittal anorectoplasty (PSARP) has advanced anorectal malformation (ARM) treatment, yet challenges persist. Pediatric surgeons continue striving for better patient outcomes despite nearly 40 years of the PSARP era.

Keywords:
Anorectal malformationComplicationConstipationFecal incontinenceImperforate anusPSARP

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Area of Science:

  • Pediatric Surgery
  • Surgical Innovation
  • Congenital Anomalies

Background:

  • Anorectal malformations (ARM) represent complex congenital anomalies requiring specialized surgical intervention.
  • The introduction of posterior sagittal anorectoplasty (PSARP) marked a significant advancement in ARM management.
  • Despite progress, ARM treatment remains challenging due to anomaly variability and persistent short- and long-term issues.

Purpose of the Study:

  • To review the impact and evolution of posterior sagittal anorectoplasty (PSARP) in treating anorectal malformations (ARM).
  • To highlight the ongoing challenges and future directions in pediatric surgical management of ARM.
  • To emphasize the commitment of pediatric surgeons to improving the physical and social health of ARM patients.

Main Methods:

  • Review of the historical development and widespread adoption of PSARP.
  • Analysis of the progress achieved in ARM treatment since the advent of PSARP.
  • Discussion of persistent challenges and the variability of ARM.

Main Results:

  • PSARP has become a globally recognized technique, significantly improving ARM treatment.
  • Substantial progress has been made in the contemporary management of ARM.
  • Despite advancements, challenges related to the anomaly's nature and variability persist.

Conclusions:

  • PSARP has revolutionized ARM treatment, but challenges remain.
  • Pediatric surgeons are dedicated to further optimizing care for ARM patients.
  • Continuous efforts are needed to address the complexities of ARM and improve long-term patient well-being.