Long-term functional results after perineal surgery for low anorectal anomalies

Aberrations of the intrinsic innervation of the anorectum in fetal rats with anorectal malformations

“…In low ARMs, the myenteric plexuses labeled with VIP were qualitatively normal, but the number of VIPimmunoreactive cell bodies per ganglion and the density of the nerve fibers in the plexus were midway between that seen in control rats and those with high ARMs. This finding is consistent with the long-term observations of Ong and Beasley [2] and Rintala et al [17] that a high proportion of children with low ARMs has ongoing problem with constipation, requiring dietary or medical management.…”

“…Intramural nerves stained by VIP and SP-100 antisera were decreased in both types of ARM, indicating that both inhibitory and excitatory motor neural elements were affected, and this may explain the distal colonic dysmotility seen postoperatively in both high and low ARMs. D 2005 Elsevier Inc. All rights reserved.Children with repaired anorectal malformations (ARMs) often have ongoing morbidity from fecal accumulation, constipation, soiling, and incontinence [1][2][3][4][5][6][7]. In the past, it has been assumed that these symptoms resulted from abnormalities of the sacral roots and damage to the anorectal nerves during surgery [8][9][10][11].…”

Fistulectomy and anoplasty for low imperforate anus with anoperineal fistula in boys

“…A majority of patients reaching adolescence and adulthood are able to maintain themselves as socially continent [8]. Early survival is a rule today, except in some rare cases with cardiac, urogenital, or chromosomal anomalies that are not compatible with life.…”