Division of Pediatric Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan; School of Medicine, Mackay Medical College, New Taipei City, Taiwan.
Division of Pediatric Surgery, Department of Surgery, Mackay Memorial Hospital, Hsinchu, Taiwan.
Pediatr Neonatol. 2020 Feb;61(1):58-62. doi: 10.1016/j.pedneo.2019.05.010. Epub 2019 Jun 12.
To evaluate the occurrence of constipation after anorectal malformations (ARM) repair and the results of laxative treatment.
Between August 2012 and July 2017, the clinical data of patients with ARMs was prospectively collected. The patients were divided into two groups, good types and poor types. Good types included rectoperineal, rectovestibular, rectourethral bulbar, and no fistula. Risk factors were defined as spinal cord anomalies, sacral ratio <0.4, or cognitive impairment. Success was defined as that laxative could be tapered.
Eighty-four patients were enrolled with mean age of 6.3 ± 7.8 (0.6-59.9) years. The mean age of onset of constipation was 12.8 ± 8.3 months and the mean interval was 5.9 ± 5.1 months after reconstructions. The interval was not significantly different between patients with good types and poor types. In 23 patients with severe constipation being treated for >6 months, 14 of 18 (77.8%) patients with good types were classified as success, whereas only 1 of 5 (20%) patients with poor types was (p = 0.02). In patients with good types, 9 of 9 (100%) patients with no risk factors were successful; however, only 5 out of 9 (55.6%) patients with risk factors were successful (p = 0.02).
Constipation occurs shortly after operations. Patients with good types and no risk factors are susceptible to weaning laxatives.
评估肛门直肠畸形（ARM）修复后便秘的发生情况及泻药治疗效果。
2012 年 8 月至 2017 年 7 月，前瞻性收集 ARM 患者的临床资料。将患者分为良好型和不良型。良好型包括直肠会阴型、直肠前庭型、直肠尿道球部型和无瘘管型。危险因素定义为脊髓畸形、骶骨比值<0.4 或认知障碍。成功定义为可以逐渐减少泻药剂量。
共纳入 84 例患者，平均年龄为 6.3±7.8（0.6-59.9）岁。便秘的平均发病年龄为 12.8±8.3 个月，重建后平均间隔为 5.9±5.1 个月。良好型和不良型患者的间隔无显著差异。在 23 例严重便秘且治疗时间>6 个月的患者中，18 例（77.8%）良好型患者中有 14 例被归类为成功，而 5 例（20%）不良型患者中仅 1 例（p=0.02）。在良好型患者中，9 例（100%）无危险因素的患者成功；然而，9 例（55.6%）有危险因素的患者中仅 5 例成功（p=0.02）。
便秘在手术后不久即发生。无危险因素的良好型患者容易减少泻药剂量。
