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. 2022 Jun 1;74(6):782-787.
doi: 10.1097/MPG.0000000000003447. Epub 2022 Apr 19.

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

Françoise Schmitt  1 , Aurélien Scalabre  2 , Pierre Yves Mure  3 , Claude Borrione  4 , Jean Louis Lemelle  5 , Dyuti Sharma  6 , Stéphan De Napoli  7 , Sabine Irtan  8 , Guillaume Levard  9 , François Becmeur  10 , Philippe Buisson  11 , Laurent Fourcade  12 , Alexis Arnaud  13 , Philine De Vries  14 , Sophie Branchereau  15 , Cynthia Garignon  16 , Frédérique Sauvat  17 , Nicolas Kalfa  18 , Hubert Lardy  19 , Sandy Jochault-Ritz  20 , Emmanuel Sapin  21 , Hélène Coridon  22 , Marc Margaryan  23 , Myriam Pouzac  24 , Luana Carfagna  25 , Marie Laurence Polimerol  26 , François Varlet  2 , Sabine Sarnacki, Célia Cretolle  27 , Guillaume Podevin  1
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Free article

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

Françoise Schmitt et al. J Pediatr Gastroenterol Nutr. .
Free article

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.

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Conflict of interest statement

The authors report no conflicts of interest.

References

    1. Holschneider A, Hutson J, Peña A, et al. Preliminary report on the international conference for the development of standards for the treatment of anorectal malformations. J Pediatr Surg 2005; 40:1521–1526.
    1. Peña A, Hong A. Advances in the management of anorectal malformations. Am J Surg 2000; 180:370–376.
    1. Solomon BD. VACTERL/VATER Association. Orphanet J Rare Dis 2011; 6:56.
    1. Hassett S, Snell S, Hughes-Thomas A, et al. 10-Year outcome of children born with anorectal malformation, treated by posterior sagittal anorectoplasty, assessed according to the Krickenbeck classification. J Pediatr Surg 2009; 44:399–403.
    1. Maerzheuser S, Schmidt D, Mau H, et al. Prospective evaluation of comorbidity and psychosocial need in children and adolescents with anorectal malformation. Part 1: paediatric surgical evaluation and treatment of defecating disorder. Pediatr Surg Int 2009; 25:889–893.

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