Assessing the benefit of reoperations in patients who suffer from fecal incontinence after repair of their anorectal malformation
jpedsurg.org shows its articles on its own site.
Read the article on jpedsurg.org ↗Article · Jul 2020 · 1 min read
In brief
In brief
This retrospective study evaluates functional outcomes in 153 patients who underwent redo posterior sagittal anorectoplasty (PSARP) for complications after initial anorectal malformation repair. At one year post-reoperation, 77% of patients achieved fecal continence or near-continence through laxatives or enema management, with significant improvements in quality of life and continence scores.
Written by the GCMD Library team from the article.
Background and Aim
Patients with a previously repaired anorectal malformation (ARM) can suffer from complications which lead to incontinence. Reoperation can improve the anatomic result, but its impact on functional outcomes is unclear.
Methods
We performed a retrospective cohort study of patients with a previously repaired ARM who underwent redo PSARP at our Center and compared results at initial assessment and 12 months after redo.
Results
One hundred fifty-three patients underwent a redo PSARP for anoplasty mislocation (n=93, 61%), stricture (n=55, 36%), remnant of the original fistula (n=28, 18%), or rectal prolapse (n=11, 7%). Post-redo complications included stricture (n=33, 22%) and dehiscence (n=5, 3%). At 1-year post-redo, 75/153 (49%) are on laxatives only, of whom 57 (76%) are continent of stool. Of the remaining 78 (51%) patients, 61 (78%) are clean (≤1 accident per week) on enemas. Interestingly, 16/79 (20%) of patients with expected poor continence potential were continent of stool on laxatives. Overall, 118/153 (77%) are clean after their redo. Quality of life (76.7 vs. 83.8, p=0.05) and Baylor continence (29.2 vs. 17.7, p=