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Constipation after surgery for anorectal malformations: Unrecognised problem until it is a problem.

Vijai D Upadhyaya1, Laxmi K Bharti2, Ashwani Mishra1

  • 1Department of Pediatric Surgical Superspecialties, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

African Journal of Paediatric Surgery : AJPS
|February 17, 2021
PubMed
Summary
This summary is machine-generated.

Constipation is a frequent complication following anorectal malformations (ARMs) surgery. Management involves non-operative strategies for most patients, with surgery reserved for persistent cases.

Keywords:
Anorectal malformationsbowel management programmeconstipationredo-surgery

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Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Colorectal Surgery

Background:

  • Constipation is a common postoperative complication in patients with anorectal malformations (ARMs), particularly those undergoing pull-down surgery with preserved rectosigmoid.
  • This study reviews the experience and management of constipation in patients post-ARM surgery.

Purpose of the Study:

  • To present the experience with managing constipation in patients after anorectal malformation surgery.
  • To discuss the outcomes of operative and non-operative management strategies.

Main Methods:

  • Retrospective review of electronic operative and follow-up data from January 2015 to December 2019.
  • Inclusion of patients experiencing constipation after ARM surgery.

Main Results:

  • 77 patients were analyzed, with constipation occurring across various ARM subtypes.
  • Non-operative management was successful in 75.44% of cases; surgery was performed in 41.56%.
  • 72.88% of patients achieved continence, while 27.19% required intermittent laxatives or enemas.

Conclusions:

  • Constipation is a significant issue post-ARM surgery, especially after pull-down procedures.
  • Creating a larger neoanus and early dilatation are recommended, particularly in redo cases.
  • Early intervention with counseling, laxatives, and dietary changes is crucial for managing constipation.