Bowel function after surgery in male children with complicated anorectal malformations

BackgroundSome children may experience defecation dysfunction following surgery for anorectal malformations. This study evaluated the long-term functional outcomes and influencing factors in male children with complicated anorectal malformations (ARMs).MethodsWe retrospectively analyzed the clinical...

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Main Authors: Hanbin Zhao, Jian Cao, Jinping Hou, Yuan Shi, Yi Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1621535/full
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author Hanbin Zhao
Jian Cao
Jinping Hou
Yuan Shi
Yi Wang
author_facet Hanbin Zhao
Jian Cao
Jinping Hou
Yuan Shi
Yi Wang
author_sort Hanbin Zhao
collection DOAJ
description BackgroundSome children may experience defecation dysfunction following surgery for anorectal malformations. This study evaluated the long-term functional outcomes and influencing factors in male children with complicated anorectal malformations (ARMs).MethodsWe retrospectively analyzed the clinical data of male children with complicated ARMs who underwent staged surgeries in our hospital from 2013 to 2016. Data collected included ARM type, perianal muscle development, anorectal manometry findings, lumbosacral MRI findings and the intervals between the first and third operation. Bowel function after the operation was assessed by questionnaire (modified Rintala score). Logistic regression analysis was used to analyze the influencing factors of prognosis.ResultsFifty-eight children were included in this study, with a median age at PSARP of 6.7 months. Bowel function did not differ based on anorectal malformations subtype (p = 0.212). Perianal muscle development was significantly associated with bowel function (p = 0.023, rs = 0.297). Fifty-one children received anorectal manometry, which showed no significant differences in anal resting pressure (ARP) among the different bowel function groups(p = 0.666). Rectoanal inhibitory reflex (RAIR) was present in 3/12 (25%), 10/36 (27.8%), and 1/3 (33.3%) children in the normal, good, and fair groups, respectively (p = 0.781). Bowel function was significantly worse in children with spinal cord anomalies than in children with normal spinal cord (OR = 4.651, p = 0.032). Stooling level worsened with increasing intervals between the first and third operation (OR = 3.808, p = 0.039).ConclusionThe incidence of spinal cord abnormalities in male children with complicated ARMs was high. Spinal cord anomalies and long intervals of the staging operation increased the risk of poor postoperative outcomes.
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spelling doaj-art-d31fd139e8c0477eaeb45cdbddfa2bdf2025-08-20T02:32:57ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-06-011310.3389/fped.2025.16215351621535Bowel function after surgery in male children with complicated anorectal malformationsHanbin Zhao0Jian Cao1Jinping Hou2Yuan Shi3Yi Wang4Department of General Surgery &Neonatal Surgery, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of General Surgery &Neonatal Surgery, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of General Surgery &Neonatal Surgery, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Neonatology, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of General Surgery &Neonatal Surgery, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaBackgroundSome children may experience defecation dysfunction following surgery for anorectal malformations. This study evaluated the long-term functional outcomes and influencing factors in male children with complicated anorectal malformations (ARMs).MethodsWe retrospectively analyzed the clinical data of male children with complicated ARMs who underwent staged surgeries in our hospital from 2013 to 2016. Data collected included ARM type, perianal muscle development, anorectal manometry findings, lumbosacral MRI findings and the intervals between the first and third operation. Bowel function after the operation was assessed by questionnaire (modified Rintala score). Logistic regression analysis was used to analyze the influencing factors of prognosis.ResultsFifty-eight children were included in this study, with a median age at PSARP of 6.7 months. Bowel function did not differ based on anorectal malformations subtype (p = 0.212). Perianal muscle development was significantly associated with bowel function (p = 0.023, rs = 0.297). Fifty-one children received anorectal manometry, which showed no significant differences in anal resting pressure (ARP) among the different bowel function groups(p = 0.666). Rectoanal inhibitory reflex (RAIR) was present in 3/12 (25%), 10/36 (27.8%), and 1/3 (33.3%) children in the normal, good, and fair groups, respectively (p = 0.781). Bowel function was significantly worse in children with spinal cord anomalies than in children with normal spinal cord (OR = 4.651, p = 0.032). Stooling level worsened with increasing intervals between the first and third operation (OR = 3.808, p = 0.039).ConclusionThe incidence of spinal cord abnormalities in male children with complicated ARMs was high. Spinal cord anomalies and long intervals of the staging operation increased the risk of poor postoperative outcomes.https://www.frontiersin.org/articles/10.3389/fped.2025.1621535/fullanorectal malformationsbowel functionspinal cord anomaliesoperation intervalsperianal muscle
spellingShingle Hanbin Zhao
Jian Cao
Jinping Hou
Yuan Shi
Yi Wang
Bowel function after surgery in male children with complicated anorectal malformations
Frontiers in Pediatrics
anorectal malformations
bowel function
spinal cord anomalies
operation intervals
perianal muscle
title Bowel function after surgery in male children with complicated anorectal malformations
title_full Bowel function after surgery in male children with complicated anorectal malformations
title_fullStr Bowel function after surgery in male children with complicated anorectal malformations
title_full_unstemmed Bowel function after surgery in male children with complicated anorectal malformations
title_short Bowel function after surgery in male children with complicated anorectal malformations
title_sort bowel function after surgery in male children with complicated anorectal malformations
topic anorectal malformations
bowel function
spinal cord anomalies
operation intervals
perianal muscle
url https://www.frontiersin.org/articles/10.3389/fped.2025.1621535/full
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AT jiancao bowelfunctionaftersurgeryinmalechildrenwithcomplicatedanorectalmalformations
AT jinpinghou bowelfunctionaftersurgeryinmalechildrenwithcomplicatedanorectalmalformations
AT yuanshi bowelfunctionaftersurgeryinmalechildrenwithcomplicatedanorectalmalformations
AT yiwang bowelfunctionaftersurgeryinmalechildrenwithcomplicatedanorectalmalformations