Treatment of Children with Anorectal Malformations—10-Year Review

Abstract

Introduction: Anorectal malformations include a wide spectrum of congenital defects of the anus, anal canal and rectum, which are often combined with urogenital tract defects. They are often associated with congenital anomalies of other organ systems such as genitourinary, cardiovascular, digestive, skeletal, etc. Objectives: This study aimed to review the patients with anorectal malformations, diagnosis, different types of associated anomalies and their frequency, modalities of treatment, results of treatment and complications. Materials and Methods: Since 2010, we have performed a combined retrospective and prospective analysis of a total of 76 patients with anorectal malformations which were diagnosed and treated at our clinic between 2005 and 2014. Results: Of 76 patients with anorectal malformations, 48 were male (63.16%) and 28 female (36.84%). Anal stenosis was the commonest type (30.26%) followed by ARM without fistula (25.00%) and rectourethral fistula (18.42%). The most common associated anomalies were urogenital (49.12%), cardiovascular (21.05%), gastrointestinal (15.79%), and bone malformations (5.26%). 34 patients (44.74%) were treated primarily without colostomy. In 40 patients (52.63%) colostomy was performed after birth. PSARP was the procedure of choice in 76.92% of patients. 7 patients (9.21%) died in total. Constipation was present in 52.38% of all patients. Patients older than 3 years of age totally continent were 30.91%. Redo operations were performed in 5 patients (7.94%). Conclusion: Early diagnosis of anorectal malformations is very important. Some malformations such as anal stenosis are sometimes diagnosed beyond the neonatal age. Challenging problem still remains high percentage of children that suffer from fecal incontinence and constipation.

Study of Cases of Arm in Rural Population

“…This slightly differed from the Distribution of Patients according to type of Defect in a study conducted by Osagie et al (2016) [9] in which High anorectal malformation accounted for 33 (34.4%) cases, the intermediate 15 (15.6%) and the low types were 48 (50%) and in a study conducted by Statovci et al (2015) [8 Thus the High defects were more common in males whereas Intermediate defects were more common in Females. This is in accordance with study Conducted by Bhargava et al (2006 ).…”

Terapi Bermain: Dongeng Dalam Menurunkan Nyeri Pada Pasien Anak Dengan Fistula Rektovestibular

“…Pada jenis MAR seperti fistula rektovestibular memerlukan penanganan bedah yang diawali dengan tindakan kolostomi (Statovci et al, 2015). Kemudian dilanjut dengan tindakan Posterosagital Anorectoplasty (PSARP) sebagai pendekatan standar yang dilakukan untuk semua jenis imperforasi anus (Devries, 2001).…”

Surgical correction of rectal atresia with recto-vestibular fistula

“…Кроме того, что он наиболее часто встречается среди всех аноректальных пороков, он обладает и другими особенностями: передняя стенка прямой кишки интимно прилежит к задней стенке влагалища, свищ низко расположен к анальному отверстию, легко бужируется, обеспечивая длительное удовлетворительное опорожнение кишечника. Перечисленные анатомические и функциональные особенности изолированных ректовестибулярных свищей определяют известную степень их своеобразия, в особенности к выбору унифицированного подхода их хирургического лечения [2,3]. Здесь как раз и развернулась дискуссия, которая не прекращается и в настоящее время.…”

“…Здесь как раз и развернулась дискуссия, которая не прекращается и в настоящее время. Она идет в основном по двум направлениям: в отношении использования колостомии и способов мобилизации прямой кишки (из переднего промежностного [1,2] или заднесагиттального [3,4]…”