Functional continence in anorectal malformation after posterior sagittal anorectoplasty

A. Arief  Munandar; Ahmadwirawan; Nita  Mariana; M. Ihwan Kusuma; Sulmiati; Sachraswaty R. Laidding; Muhammad  Faruk

doi:10.23750/abm.v95i6.15713

Functional continence in anorectal malformation after posterior sagittal anorectoplasty

Authors

A. Arief Munandar Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Ahmadwirawan Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia https://orcid.org/0000-0001-5671-596X
Nita Mariana Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia https://orcid.org/0000-0002-9236-0008
M. Ihwan Kusuma Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia https://orcid.org/0000-0002-5414-1859
Sulmiati Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia https://orcid.org/0000-0002-6287-2221
Sachraswaty R. Laidding Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia https://orcid.org/0000-0002-4303-971X
Muhammad Faruk Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia https://orcid.org/0000-0002-7079-4585

DOI: https://doi.org/10.23750/abm.v95i6.15713

Keywords:

anorectal malformation, outcome, functional, posterior sagittal anorectoplasty

Abstract

Background and aim: Incontinence remains a surgical challenge for patients with anorectal malformations. This study aimed to determine the outcome function of continence in anorectal malformation patients after posterior sagittal anorectoplasty (PSARP) at Dr. Wahidin Sudirohusodo Hospital, considering gender; type of anorectal malformation; sacral ratio; vertebral, anal, cardiac, tracheal, esophageal, renal, and limb (VACTERL) anomalies; and age when undergoing PSARP.

Methods: This descriptive, analytical, cross-sectional study used primary data (Rintala questionnaire) and secondary data (medical records) at single-center hospitals in Makassar, Indonesia. It investigated 39 patients who had received PSARP over 5 years.

Results: Of the 39 patients, 24 (61.5%) were male, and 15 (38.5%) were female. The age at which PSARP was performed was £6 months for 22 (56.4%) patients and after 6 months for 17 (43.6%) patients. A relationship existed between the age when PSARP was performed and continence outcomes (p=0.034). Patients who were treated at younger than 6 months had better continence function than those who underwent PSARP after 6 months. The type of anorectal malformation has no influenced the functional outcome of PSARP: most patients with no fistula type 19 (48.7%) (p=0.198). Patients without VACTERL anomalies had better functional outcomes than patients with VACTERL anomalies.

Conclusions: Functional outcomes in anorectal malformation patients were related to the age at which PSARP was performed, type of anorectal malformation, and presence of VACTERL anomalies. The sacral ratio had no relationship with functional outcomes.

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