Ghorbanpoor Manoochehr, Dehvan Behzad, Rahimi Siavash, Pirdehghan Azar
Department of Surgery, Hamadan University of Medical Sciences, Hamadan, Iran.
School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Scientifica (Cairo). 2018 May 30;2018:8297617. doi: 10.1155/2018/8297617. eCollection 2018.
Fecal incontinence is one of the worst functional complications of posterior sagittal anorectoplasty for treatment of anorectal malformation.
In this study, we aimed to identify the prevalence of fecal incontinence in patients with the diagnosis of high or low anorectal malformation who underwent three-stage posterior sagittal anorectoplasty surgery in our center.
Children with the diagnosis of anorectal malformation who underwent posterior sagittal anorectoplasty at the Department of Pediatric Surgery of Besat Hospital, Hamadan University of Medical Sciences, Iran, from 2012 to 2016 were enrolled in the study. Parents or guardians were recruited and asked to fill the study questionnaire including the Templeton and Ditesheim Scoring System to assess the status of fecal continence of the patients.
Thirty-four patients including 10 (29.4%) males were enrolled in the study. High type of anorectal malformation was diagnosed in 23 (67.6%) patients. The overall mean scores of fecal continence were 4.57 ± 0.84 (range 1.5-5) after a mean follow-up time of 50.7 (range 22.5-69.8) months. Good fecal continence was observed in 91.3% of patients with low type compared to 72.8% of patients with high type of anorectal malformation; however, the difference was not significant (=0.13).
Posterior sagittal anorectoplasty surgery in patients with anorectal malformation may result in acceptable fecal continence.
大便失禁是后矢状入路肛门直肠成形术治疗肛门直肠畸形最严重的功能并发症之一。
在本研究中，我们旨在确定在我们中心接受三期后矢状入路肛门直肠成形术的高或低位肛门直肠畸形患者中大便失禁的发生率。
纳入2012年至2016年在伊朗哈马丹医科大学贝萨特医院小儿外科接受后矢状入路肛门直肠成形术的肛门直肠畸形患儿。招募家长或监护人并要求他们填写研究问卷，包括Templeton和Ditesheim评分系统，以评估患者的大便失禁状况。
34例患者纳入研究，其中男性10例（29.4%）。23例（67.6%）患者被诊断为高位肛门直肠畸形。平均随访50.7（范围22.5 - 69.8）个月后，大便失禁的总体平均评分为4.57±0.84（范围1.5 - 5）。低位畸形患者中91.3%大便控制良好，而高位肛门直肠畸形患者中这一比例为72.8%；然而，差异无统计学意义（P = 0.13）。
肛门直肠畸形患者接受后矢状入路肛门直肠成形术可能会获得可接受的大便控制情况。
