Long-term (> 10 years) bowel function of anorectal malformations: a retrospective single-center study
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In brief
In brief
This retrospective study of 81 ARM patients with >10-year follow-up demonstrates generally favorable long-term bowel function (85% satisfactory outcomes) and quality of life. Reoperations, particularly for fistula recurrence, were the primary factor associated with poor outcomes, emphasizing the critical importance of successful primary anorectoplasty.
- 85% of ARM patients achieved satisfactory bowel function (Rintala score ≥17) at >10 years post-repair, indicating favorable long-term outcomes.
- Reoperations, most commonly for recto-urethral fistula recurrence, significantly correlate with poor bowel function scores.
- Defecation problems primarily impact psycho-social health rather than physical health in ARM patients with long-term follow-up.
- Quality of life correlates positively with bowel function scores (r=0.648), emphasizing the importance of achieving continence.
- Primary anorectoplasty quality is critical—avoiding reoperations is key to optimizing long-term functional outcomes in ARM.
Written by the GCMD Library team from the article.
Abstract
Purpose
To describe the long-term bowel function of anorectal malformation (ARM) patients and explore the potential influence factors.
Methods
ARM patients with follow-up data > 10 years were included. Cases of cloaca, Currarino syndrome, and VACTERL syndrome were excluded. Rintala score and PedsQL 4.0 were used to assess bowel function score (BFS) and quality of life (QoL). Based on the results, patients were divided into satisfactory group with BFS ≥ 17 and unsatisfactory group with it < 17. Comparisons between the groups were made.
Results
Among the 81 patients were 44 males and 37 females. Follow-up time was 138 (126,151) months. 16 (19.75%) patients had associated anomalies. 23 (28.40%) patients had reoperations, and fistula recurrence was the most common reason. BFS of the patients was 20 (18,20). QoL score was 100 (100,100), which correlated positively with BFS (r = 0.648, P < 0.001). The satisfactory and the unsatisfactory groups had 69 and 12 cases, and their BFS were 20 (20,20) and 11 (8,15) respectively, which had statistical difference (P < 0.001). Total QoL score and psycho-social health score of the unsatisfactory group were lower (P < 0.001). Only reoperations were statistically different between the groups (P < 0.001).
Conclusions
Long-term (> 10 years) bowel function of ARM patients is good in this study. Defecation problems have negative impacts on QoL and mainly affects their psycho-social health. Primary anorectoplasty is extremely important. Reoperations, which are most commonly seen in recto-urethral fistula recurrence, adversely affect the outcome.