Prognostic Factors for Functional Outcomes of Anorectal Malformation Patients Following Definitive Surgery

Introduction: Anorectal malformation (ARM) is one of the most common congenital anomalies found in pediatric surgery. The consensus asserts that fecal continence represents the most crucial endpoint in patients with anorectal malformations post-definitive surgery. We aimed to analyze the functional outcomes in ARM patients after a definitive surgery using Rintala scoring. Methods: This study was a retrospective design using medical records of ARM patients who underwent a definitive surgery at our institution from 2012 to 2016. Results: Forty-five ARM patients were ascertained in this study, of whom 25 were males and 20 were females. There are 66.7 of patients with high lesions and 33.3 of patients with low lesions. Most patients showed the ability to withhold defecation and experience the urge to defecate (48.9) and defecation frequency of every day or twice a day (66.7). Soiling was identified in 11.1 of subjects, while constipation was found in 22.2 of patients. None of the patients revealed accidents and social problems. High lesion ARM patients showed worse for having the ability to withhold defecation/sensation of the urge to defecate (OR=5.29, 95 CI=1.44-19.45) than low lesion ARM subjects (p=0.010). In addition, high lesion ARM patients showed a higher risk of having abnormal Rintala score (OR=5.11, 95 CI=1.33-19.72) than low lesion ARM subjects (p=0.014). Conclusion: Our study shows relatively good functional outcomes of ARM patients following definitive surgery. High lesions of ARM might affect the ability to hold back defecation, feels the urge to defecate, and the overall Rintala score in ARM patients after definitive surgery.