Early versus delayed repair in patients with anorectal malformation with rectoperineal fistula: impact on short-term complications and midterm and long-term bowel function.
Xianming Xiao, Wei Feng, Chenzhu Xiang, Liang Yuan, Zhili Wang, Jinping Hou, Yi Wang
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引用次数: 0
Abstract
Background: This study aims to investigate the impact of early versus delayed repair on early postoperative complications and midterm and long-term bowel function in ARM patients with rectoperineal fistula.
Methods: A total of 568 ARM patients with rectoperineal fistula who underwent cutback anoplasty were identified at our hospital from 2015 to 2021. Early repair was defined as an anoplasty performed at or before 28 days of age. Delayed repair was defined as occurring after this period.
Results: 267 patients were finally enrolled, with 171 males and 96 females. 129 (48.3%) underwent early repair and 138 (51.7%) delayed repair. Early postoperative complication rates showed no significant difference between the two groups (0% vs. 0.7%, P = 1.000). No wound infections or dehiscence occurred in either group within 6 months postoperatively. The median Rintala score did not differ significantly between the early and delayed groups (20 vs. 20, P = 0.272). Based on the Krickenbeck classification, there were no significant differences between the groups regarding constipation, soiling, or voluntary bowel movements (P > 0.05).
Conclusions: Early and delayed repair have no significant impact on early postoperative complications and midterm and long-term bowel function in ARM patients with rectoperineal fistula. Neonatal cutback anoplasty is safe and effective for stable patients without major comorbidities, offering a favorable prognosis.
背景：本研究旨在探讨早期修复与延迟修复对直肠会阴瘘ARM患者早期术后并发症和中长期肠功能的影响。方法：2015年至2021年，我院共收治568例直肠会阴瘘行切口肛瘘成形术的ARM患者。早期修复被定义为在28日龄或之前进行的肛门成形术。延迟修复被定义为发生在这段时间之后。结果：最终纳入267例患者，其中男性171例，女性96例。早期修复129例（48.3%），延迟修复138例（51.7%）。两组术后早期并发症发生率无显著差异（0% vs. 0.7%, P = 1.000）。两组患者术后6个月内均未发生伤口感染或裂开。早期组和延迟组的中位Rintala评分无显著差异（20比20，P = 0.272）。根据Krickenbeck分类，两组在便秘、大便或排便方面无显著差异（P < 0.05）。结论：早期和延迟修复对ARM直肠会阴瘘患者术后早期并发症和中长期肠功能无显著影响。新生儿切口成形术是安全有效的稳定患者无主要合并症，提供良好的预后。
期刊介绍：
Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children.
The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include:
-Review articles-
Original articles-
Technical innovations-
Letters to the editor
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