article · BMC Pediatrics
This study evaluated functional outcomes and contributing factors in paediatric patients who underwent surgical repair for anorectal malformations at Muhimbili National Hospital over a five-year period. Reviewing 116 children with an average age of 4.4 years using the modified Krickenbeck scoring system, the analysis assessed voluntary bowel movements, constipation, and soiling. Voluntary bowel movements were achieved in 63 percent of patients, while constipation and soiling occurred in 22 percent and 15 percent of cases, respectively. Preterm birth was strongly associated with post-operative constipation, whereas performing an abdominal perineal pull-through for high anorectal malformations was significantly linked to soiling. Functional recovery showed no significant variation between male and female patients. Achieving optimum voluntary bowel movements depended primarily on patient body weight, the complexity of the malformation, and the specific surgical technique utilised.
Anorectal malformations are birth defects that require complex corrective surgery. Understanding the specific factors that influence long-term bowel control, such as birth history and surgical technique, helps clinicians better evaluate surgical risks, refine treatment strategies, and improve the overall quality of life for affected children in resource-limited healthcare environments.
The abstract does not indicate an application pathway, as it is a retrospective clinical evaluation of surgical outcomes rather than the development of a commercial product or service.
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BACKGROUND: Functional outcomes after definitive surgical reconstruction in the management of Anorectal malformations (ARM) patients have not been adequately studied in the third-world countries. OBJECTIVE: This retrospective cross sectional analytical study aimed at evaluating the functional outcome and attributable factors following the definitive reconstruction surgery among children with ARM at Muhimbili National Hospital. METHODS: Patients with ARM who underwent definitive reconstruction surgery between 2017 and 2021 were recruited in the current study using the consecutive sampling method. The functional outcome and severity were assessed using the modified Krickenbeck scoring system.Analysis was performed using STATA version 16.0. RESULTS: 116 pediatric patients with ARM who underwent definitive surgical repair were reviewed, the mean age was 4.4 (SD1.8) years. The male-to-female ratio was 1.1:1. The functional outcome was voluntary bowel movement (VBM), constipation, and soiling with a prevalence of 63%, 22%, and 15% of patients respectively. Babies born preterm shows significant association with constipation with P- the value of 0.003, OR 13.26, and 95% CI 2.48-70.87. Abdominal perineal pull-through among patients who had High ARM showed a significant association with soiling (P-value 0.001, OR 0.03, and 95% CI of 0.01-0.16). CONCLUSION: In the current study we identified that there is no significant variation in ARM functional outcome between males and females.However some factors such as the type of surgery, patient body weight and the complexity of anorectal malformation were all decisive factors for achieving the optimum Voluntary Bowel Bovement (VBM) following ARM repair surgery.
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DOI: 10.1186/s12887-025-05560-5
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