Change over time in the postoperative defecation function in female patients with anovestibular fistula at a single institution: focus on the comparison of anal transposition with anterior sagittal anorectoplasty
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In brief
In brief
This retrospective study of 88 female patients with anovestibular fistula compares long-term bowel function outcomes between anal transposition and anterior sagittal anorectoplasty techniques over a 37-year period. Both surgical approaches achieved excellent evacuation scores by age nine, though anal transposition showed better constipation control while ASARP demonstrated superior soiling outcomes.
Written by the GCMD Library team from the article.
Abstract
Purpose
Anovestibular fistula (AVF) is the most common type of ARM in female patients. The present study investigated changes over time in the postoperative defecation function of female patients with AVF.
Methods
Patient data were collected from 1984 to 2021. Eighty-eight female patients with AVF were enrolled. Patients’ characteristics and the long-term outcome of defecation function were reviewed and analyzed retrospectively. The bowel function was evaluated according to the Japan Society of ARM Study Group evacuation score (ES).
Results
Thirty-eight patients underwent anal transposition (AT), and 8 underwent anterior sagittal anorectoplasty (ASARP). The total evacuation score (ES) in AVF patients reached “excellent” at nine years old, regardless of the operative procedure. The constipation scores with AT showed better improvement than those with ASARP, but soiling scores in the ASARP group showed better improvement than those in the AT group. The postoperative complications did not affect the postoperative bowel function in AVF patients.
Conclusion
Most patients with AVF eventually achieved a satisfactory total ES. Given the difference in defecation score transition depending on the operative procedure or postoperative complications, it may be important to perform long-term defecation management via surgical procedures.