Anorectal Malformations: Epidemiological, Clinical, Therapeutic and Evolutionary Aspects in the General Surgery Department of the Sominé DOLO Hospital of Mopti

M. K, Diaby, S, M. A, D. S, C. B, Kone, M. C, K. O, S. B, K. M, K. D, F. D
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Abstract

We conducted a retrospective and prospective study. In our study, we collected 35 cases of MAR, including 21 boys and 14 girls, over a period of 4 years, from January 2017 to December 2020. We recorded an average of 8.7 cases of ADR per year. They are more frequent in boys, with a sex ratio of 1.5. The majority of our patients came from the Mopti region and were of Dogon ethnicity. Most of the malformations were discovered by the parents, given that 54.3% of the mothers had given birth in a health centre and the malformed children were most often seen in a state of intestinal obstruction or sub-occlusion requiring an emergency colostomy. The diagnosis was made during the systematic examination of the newborn in the delivery room in 8.57% of our patients. Low forms were more frequent (48.6%). Invertograms were performed in 15 patients (42.9%). Abnormalities associated with MAR were dominated by spinal malformations in 4 cases (11.4%). In terms of treatment, the operative techniques used, in order of frequency, were: ASARP 8 cases (30.8%); Pena PSARP 15 cases (57.7%), YV Proctoplasty 2 cases (7.7%) and PENA PSARP plus MOLLARD AP 1 case (3.8%). Average follow-up was 12 months. Four (4) patients (15.4%) were lost to follow-up. Post-operative follow-up was favourable in 17 patients (65.4%); 4 cases of death and 1 case of anal stenosis.
肛门直肠畸形:莫普提 Sominé DOLO 医院普通外科的流行病学、临床、治疗和演变问题
我们开展了一项回顾性和前瞻性研究。在 2017 年 1 月至 2020 年 12 月的 4 年时间里,我们收集了 35 例 MAR,其中包括 21 名男孩和 14 名女孩。我们平均每年记录到 8.7 例 ADR。男孩的发病率更高,男女比例为 1.5。大多数患者来自莫普提地区,属于多贡族。大多数畸形都是由父母发现的,因为54.3%的母亲都是在医疗中心分娩的,而且畸形儿最常见的症状是肠梗阻或次闭塞,需要紧急结肠造口术。有 8.57% 的患者是在产房对新生儿进行系统检查时确诊的。低位的诊断率更高(48.6%)。对 15 例患者(42.9%)进行了倒置造影。与MAR相关的异常主要是脊柱畸形,有4例(11.4%)。在治疗方面,使用的手术技术按频率排序为ASARP 8 例(30.8%);Pena PSARP 15 例(57.7%);YV 直肠成形术 2 例(7.7%);PENA PSARP 加 MOLLARD AP 1 例(3.8%)。平均随访时间为 12 个月。有四(4)名患者(15.4%)失去了随访机会。17例患者(65.4%)术后随访结果良好;4例死亡,1例肛门狭窄。
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