Research progress on risk factors of postoperative functional defecation disorder in anorectal malformation

Anorectal malformation (ARM) is a common congenital gastrointestinal malformation in neonates, which has complex pathological changes and unclear etiology. The only treatment modality currently available for ARMs is through surgical treatment to correct the deformity of the anal morphology and restore normal defecation function. In addition, the mortality rates of children with ARMs have significantly decreased as a result of recent advances in medical technology. It is important to note that despite the treatment of perianal anatomical deformities, approximately one-third of ARM patients continue to experience functional defecation disorder (FDD), which includes fecal incontinence and constipation and negatively impacts the patient's quality of life. There are still numerous questions regarding the exact cause of FDD in ARM patients following surgery. It is generally accepted that the occurrence of FDD may be related to clinical staging, structural changes in the perianal rectal muscles, anomalies of the enteric nervous system, surgical injury, etc. However, some of these factors are still controversial and require additional study to be confirmed. In this paper, we review the risk factors for FDD following surgery in ARMs, which will help us to subsequently develop appropriate interventions to enhance the anal function and improve quality of life of children with ARMs.