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Early definitive operation for patients with anorectal malformation was associated with a better long-term postoperative bowel function

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Abstract

Purpose

In general, patients with anorectal malformation (ARM) undergo surgical treatment at around 6 months of age in Japan. We aimed to clarify whether the timing of a definitive operation affects the long-term bowel function.

Methods

Patient data were collected from 1984 to 2007. Fifty-two male patients with high- and intermediate-type ARM were enrolled. Patients were classified into two groups based on their operative period: the early group (EG) underwent anorectoplasty at < 5 months of age (n = 22); the late group (LG) underwent anorectoplasty at ≥ 5 months (n = 30). The bowel function was evaluated at 3, 5, 7, 9, and 11 years of age using the evacuation score (ES) of the Japan Society of Anorectal Malformation Study Group.

Results

The total score and four functional outcomes improved chronologically with age. The constipation score in the EG showed significantly better improvement in comparison to the LG. The total score and the incontinence score in the EG were significantly higher than those in the LG at 11 years of age.

Conclusion

The long-term bowel function in the EG was better than that in the LG. Anorectoplasty at an early age was important for achieving a better postoperative bowel function in ARM patients.

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Acknowledgements

We thank Mr. Brain Quinn for his comments and help with the manuscript. This study was supported by a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (JSPS: 20K08934, 20K17558, 20K10403, 20K08933, 19K10485, 19K09150, 19K09078, 19K03084, 19K18061, 19K17304, 19K18032, 18K08578, 18K16262 17K10555, 17K11514, 17K10183, 17K11515, 16K10466, 16K10094, 16K10095, 16K10434, 16H07090), research grant from The Mother and Child Health Foundation and research grant from the Kawano Masanori Memorial Public Interest Incorporated Foundation for Promotion of Pediatrics.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan

    Toshio Harumatsu, Tatsuru Kaji, Ayaka Nagano, Mayu Matsui, Keisuke Yano, Shun Onishi, Koji Yamada, Waka Yamada, Makoto Matsukubo, Mitsuru Muto & Satoshi Ieiri

  2. Clinical Training Center, Kagoshima University Hospital, Kagoshima, Japan

    Tatsuru Kaji & Waka Yamada

Authors
  1. Toshio Harumatsu
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  2. Tatsuru Kaji
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  3. Ayaka Nagano
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  9. Makoto Matsukubo
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  10. Mitsuru Muto
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  11. Satoshi Ieiri
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Corresponding author

Correspondence to Satoshi Ieiri.

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Conflict of interest

The authors declare no conflicts of interest in association with the present study.

Ethical approval

This study was performed in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects by the Ministry of Health, Labour, and Welfare of Japan in 2014. The study complied with the 1964 Declaration of Helsinki (revised in 2013) and was approved by the local ethics committee of our institution (registration number: 27-119). All participants or their parents provided their informed consent for involvement in this study.

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Harumatsu, T., Kaji, T., Nagano, A. et al. Early definitive operation for patients with anorectal malformation was associated with a better long-term postoperative bowel function. Pediatr Surg Int 37, 445–450 (2021). https://doi.org/10.1007/s00383-020-04842-6

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  • DOI: https://doi.org/10.1007/s00383-020-04842-6

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