Complications After Surgery for Anorectal Malformations: An ARM-Net consortium Registry Study.

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Congenital Abnormalities

Background:

• Postoperative complications following Anorectal Malformations (ARM) surgery are not well-defined due to limited data from single-center studies.
• Uncertainty exists regarding the influence of ARM type, congenital anomalies, prior enterostomy, and reconstructive techniques on complication rates.

Purpose of the Study:

• To establish the incidence and types of complications after surgical intervention for ARM, focusing on post-reconstruction outcomes.
• To identify patient- and treatment-related risk factors associated with these complications.

Main Methods:

• A multicenter cohort study utilizing the ARM-Net registry with prospectively collected data.
• Inclusion of patients undergoing reconstructive surgery before age five, recording enterostomy-related and post-reconstructive complications.
• Multivariable analyses were performed to determine independent risk factors for complications.

Main Results:

• 2,043 patients were analyzed; 25% experienced complications after enterostomy formation and closure (12%).
• Post-reconstructive complications occurred in 25% of patients, with wound complications being the most frequent.
• Recto-bladder neck fistula, associated anomalies, and the LAARP procedure were identified as risk factors; anoplasty and mini-PSARP were associated with reduced risk.

Conclusions:

• Post-reconstructive complications are frequent in ARM patients.
• Specific patient characteristics and surgical approaches significantly influence postoperative outcomes.
• Findings support improved patient counseling, clinical decision-making, and surgical planning for ARM.