Single-stage procedures for anorectal malformations: A systematic review and meta-analysis

Area of Science:

• Pediatric Surgery
• Colorectal Surgery
• Congenital Abnormalities

Background:

• Anorectal malformations (ARMs) are congenital conditions requiring surgical correction.
• Surgical approaches for ARMs include single-stage and staged procedures.
• Evidence on the comparative safety and efficacy of these approaches is evolving.

Purpose of the Study:

• To systematically review published studies on single-stage procedures for ARMs.
• To conduct a meta-analysis comparing single-stage to staged procedures for ARMs.
• To evaluate surgical site infection (SSI) and functional outcomes.

Main Methods:

• Comprehensive literature searches of Pubmed, Medline, Embase, and CENTRAL databases.
• Meta-analysis performed using RevMan, with results presented as forest plots.
• Odds ratios (OR) and 95% confidence intervals (CI) used for statistical analysis.

Main Results:

• Meta-analysis included 9 studies with 537 patients; 70% had perineal or vestibular fistulas.
• Single-stage procedures had a 2.2 times higher risk of SSI (OR 2.22, 95% CI 1.26, 3.92).
• No significant difference in functional outcomes (bowel movements, soiling, constipation) between approaches.

Conclusions:

• Single-stage procedures are safe for selected patients with anorectal malformations.
• Increased SSI risk with single-stage procedures did not affect long-term functional results.
• Further evidence supports the use of single-stage repair in appropriate ARM cases.