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Early definitive operation for patients with anorectal malformation was associated with a better long-term
Toshio Harumatsu1, Tatsuru Kaji1,2, Ayaka Nagano1
1Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
Insights
Early anorectoplasty surgery for anorectal malformation (ARM) leads to better long-term bowel function. Patients undergoing surgery before 5 months showed improved constipation and incontinence scores compared to those operated on later.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Malformations
Background:
- Anorectal malformation (ARM) is a congenital condition requiring surgical intervention.
- In Japan, definitive surgery for ARM typically occurs around 6 months of age.
Purpose of the Study:
- To investigate the impact of surgical timing on long-term bowel function in male ARM patients.
- To determine if early anorectoplasty improves functional outcomes.
Main Methods:
- Retrospective analysis of 52 male patients with high- and intermediate-type ARM (1984-2007).
- Patients divided into early (EG, <5 months) and late (LG, ≥5 months) surgical groups.
- Bowel function assessed using the evacuation score (ES) at ages 3, 5, 7, 9, and 11 years.
Main Results:
- Overall bowel function scores and specific outcomes improved with age in both groups.
- The early group (EG) demonstrated significantly better constipation scores.
- At 11 years, the EG had significantly higher total and incontinence scores, indicating better function.
Conclusions:
- Early anorectoplasty (before 5 months) is associated with superior long-term bowel function in ARM patients.
- Timely surgical intervention is crucial for optimizing postoperative outcomes in ARM management.
Purpose:
In general, patients with anorectal malformation (ARM) undergo surgical treatment at around 6 months of age in Japan. We aimed to clarify whether the timing of a definitive operation affects the long-term bowel function.
Methods:
Patient data were collected from 1984 to 2007. Fifty-two male patients with high- and intermediate-type ARM were enrolled. Patients were classified into two groups based on their operative period: the early group (EG) underwent anorectoplasty at < 5 months of age (n = 22); the late group (LG) underwent anorectoplasty at ≥ 5 months (n = 30). The bowel function was evaluated at 3, 5, 7, 9, and 11 years of age using the evacuation score (ES) of the Japan Society of Anorectal Malformation Study Group.
Results:
The total score and four functional outcomes improved chronologically with age. The constipation score in the EG showed significantly better improvement in comparison to the LG. The total score and the incontinence score in the EG were significantly higher than those in the LG at 11 years of age.
Conclusion:
The long-term bowel function in the EG was better than that in the LG. Anorectoplasty at an early age was important for achieving a better postoperative bowel function in ARM patients.
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