Wang Rui,Li Bixiang,Zhao Sijun.Clinical features and short-term prognoses of congenital anorectal malformations[J].Journal of Clinical Pediatric Surgery,,21():535-539.[doi:10.3760/cma.j.cn101785-202106060-007]
Clinical features and short-term prognoses of congenital anorectal malformations
- Abstract:
- Objective To explore the clinical characteristics, short-term outcomes and prognostic factors of children with congenital anorectal malformations (ARMs) at a single center.Methods From January 2015 to December 2019, retrospective analysis of clinical data was performed for 488 hospitalized ARM children.The relevant details included age, malformation type, comorbidities, surgical approaches, postoperative complications and prognoses.Results There were 350 boys and 138 girls with a median age of 2(1-89) days.There were congenital anal atresia with rectal perineal fistula (n=288), rectal vestibular fistula (n=53) and rectal urethral fistula (including bladder neck fistula, n=123), rectovaginal fistula (n=4), cloacal malformation (n=12), non-fistula (n=4) and anal stenosis (n=4).A total of 420 cases were successfully followed up.And 68 cases became lost to follow-ups with a dropout rate of 13.9%(68/488).Kelly’s score scale for postoperative anal function was excellent/good (376/420, 90%) and poor (44/420, 10%).Single factor analysis indicated that clinical type, operative procedure and infection of perianal incision were the related postoperative factors of anal function (P<0.05).Operative approach was dependent upon clinical classifications.Multiple Logistic regression analysis was employed for analyzing clinical classifications and perianal incision infection.The results indicated that both of them were the related postoperative factors of anal function (P<0.05).Conclusion Congenital anorectal malformations are more common with anal atresia plus rectal-perineal fistula.And concurrent malformations of heart and urinary system are also prevalent.Middle-to-high anal atresia and postoperative anal wound infection are two major risk factors affecting postoperative defecation function.
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Memo
收稿日期:2021-06-21。
基金项目:湖南省出生缺陷协同防治科技重大专项（2019SK1015）
通讯作者:赵斯君,Email:zhaosj3991@sohu.com