Department of Pediatrics, Mackay Memorial Hospital, Taipei City, Taiwan.
Pediatr Neonatol. 2012 Aug;53(4):252-6. doi: 10.1016/j.pedneo.2012.06.007. Epub 2012 Jul 28.
To assess whether constipation or fecal incontinence is a major late complication after posterior sagittal anorectoplasty in patients with anorectal malformation (ARM).
We retrospectively enrolled 188 children, 85 low-type ARM (L-ARM) and 103 high-type ARM (H-ARM), who had complete medical records of bowel habits and medication histories after posterior sagittal anorectoplasty for anorectal malformation in Mackay Memorial Hospital. Stool characteristics as well as physical and medication history were evaluated. The symptom severity (SS) scoring system was used to assess changes in bowel habits.
During a mean follow-up period of 4.3 years, constipation was found to be the most common late complication in both groups of patients (64.5% in the L-ARM group and 78.6% in the H-ARM group). Compared to constipation, stool incontinence was much less frequent, with 4.7% in L-ARM and 3.9% in H-ARM. There was no significant difference in mean SS scores between the two groups.
Constipation was the most common late sequela in children after correction of ARM in our study.
评估先天性肛门直肠畸形(ARM)患者行后路纵切肛门直肠成形术后便秘或粪便失禁是否为主要晚期并发症。
我们回顾性纳入了 188 例患儿,85 例低位型 ARM(L-ARM)和 103 例高位型 ARM(H-ARM),这些患儿均在马偕纪念医院行后路纵切肛门直肠成形术治疗 ARM,且具有完整的术后排便习惯和用药史记录。评估粪便特征、体格检查和用药史。采用症状严重程度(SS)评分系统评估排便习惯的变化。
在平均 4.3 年的随访期间,两组患儿均以便秘为最常见的晚期并发症(L-ARM 组为 64.5%,H-ARM 组为 78.6%)。与便秘相比,粪便失禁的发生率较低,L-ARM 组为 4.7%,H-ARM 组为 3.9%。两组间平均 SS 评分无显著差异。
在本研究中,ARM 矫正术后便秘是儿童最常见的晚期后遗症。