Long-Term Functional Outcomes of an Anorectal Malformation French National Cohort.

Abstract

OBJECTIVES:

The present study aimed to assess long-term functional outcomes of children with anorectal malformations (ARMs) across a network of expert centers in France.

METHODS:

Retrospective cross-sectional study of patients ages 6-30 years that had been surgically treated for ARM. Patient and ARM characteristics (eg, level, surgical approach) and functional outcomes were assessed in the different age groups.

RESULTS:

Among 367 patients, there were 155 females (42.2%) and 212 males (57.8%), 188 (51.2%) cases with, and 179 (48.8%) higher forms without, perineal fistula. Univariate and multivariate statistical analyses with logistic regression showed correlation between the level of the rectal blind pouch and voluntary bowel movements (odds ratio [OR] = 1.84 [1.31-2.57], P < 0.001), or soiling (OR = 1.72 [1.31-2.25], P < 0.001), which was also associated with the inability to discriminate between stool and gas (OR = 2.45 [1.28-4.67], P = 0.007) and the presence of constipation (OR = 2.97 [1.74-5.08], P < 0.001). Risk factors for constipation were sacral abnormalities [OR = 2.26 [1.23-4.25], P = 0.01) and surgical procedures without an abdominal approach (OR = 2.98 [1.29-6.87], P = 0.01). Only the holding of voluntary bowel movements and soiling rates improved with age.

CONCLUSION:

This cross-sectional study confirms a strong association between anatomical status and functional outcomes in patients surgically treated for ARM. It specifically highlights the need for long-term follow-up of all patients to help them with supportive care.

• Authors: Françoise Schmitt, Aurélien Scalabre, Pierre Yves Mure, Claude Borrione, Jean Louis Lemelle, Dyuti Sharma, Stéphan De Napoli, Sabine Irtan, Guillaume Levard, François Becmeur, Philippe Buisson, Laurent Fourcade, Alexis Arnaud, Philine De Vries, Sophie Branchereau, Cynthia Garignon, Frédérique Sauvat, Nicolas Kalfa, Hubert Lardy, Sandy Jochault-Ritz, Emmanuel Sapin, Hélène Coridon, Marc Margaryan, Myriam Pouzac, Luana Carfagna, Marie Laurence Polimerol, François Varlet, Sabine Sarnacki, Célia Cretolle, Guillaume Podevin
• Journal: Journal of pediatric gastroenterology and nutrition (J Pediatr Gastroenterol Nutr) Vol. 74 Issue 6 Pg. 782-787 (06 01 2022) ISSN: 1536-4801 [Electronic] United States
• PMID: 35849503 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

Topics

• Adolescent
• Adult
• Anal Canal (surgery)
• Anorectal Malformations (complications, epidemiology, surgery)
• Child
• Constipation (complications, etiology)
• Cross-Sectional Studies
• Defecation
• Female
• Humans
• Male
• Rectum (surgery)
• Retrospective Studies
• Young Adult