Assessing the risk factors for surgical site infections after anal reconstruction surgery in patients with anorectal malformations: a retrospective analysis
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In brief
In brief
A 10-year retrospective study of 164 pediatric patients in Japan identifies surgical site infection risk factors following anorectal malformation repair. Key finding: perianal muscle division significantly increases SSI risk in patients over 4 months with certain ARM types, suggesting surgical technique selection impacts infection outcomes.
- SSI rate after ARM reconstruction was 4%, with infections primarily occurring from neo-anus to perineal region.
- In perineal fistula, vestibular fistula, and anal stenosis cases >4 months old, perianal muscle division significantly increased SSI risk.
- Organ/space SSIs occurred specifically in rectourethral fistula (prostatic/bulbar) and perineal cutaneous fistula types.
- Surgical procedure choice is an interventional factor associated with SSI risk in ARM reconstruction.
- Multi-center retrospective data from Hokkaido (2013-2022) included 164 ARM cases across various surgical approaches.
Written by the GCMD Library team from the article.
Abstract
Purpose
This study aimed to identify surgical site infection (SSI) risk factors after anal reconstruction surgery in patients with anorectal malformations (ARMs).
Methods
This retrospective analysis from January 2013 to December 2022, including all pediatric surgical facilities in Hokkaido, Japan, examined consecutive patients with ARMs, excluding cloacal cases, regarding perioperative and SSI factors during their initial anal reconstruction surgeries.
Results
This study involved 157 cases of major clinical groups and 7 cases of rare/regional variants, among whom 4% developed SSIs. SSIs occurrence varied by type and was primarily observed from the neo-anus to the perineal region. Organ/space SSIs occurred in rectourethral fistula (prostatic/bulbar) and perineal (cutaneous) fistula type. Surgical procedures were abdominal sacroperineal rectoplasty, posterior sagittal anorectoplasty, laparoscopic-assisted anorectal pull-through, cutback anoplasty, and Pott’s anoplasty, varied based on the ARM type and facility. In perineal (cutaneous) fistula, vestibular fistula, and anal stenosis cases, a significant association was observed between perianal muscle division and SSIs in patients aged > 4 months (p = 0.04). No significant SSI factors were found in other ARM types.
Conclusion
The choice of procedure as an interventional perioperative factor is suggested to be associated with SSIs. These findings may contribute to making informed decisions regarding surgical procedures in such cases.