Anorectal Malformations in a Tertiary Pediatric Surgery Center from
Romania: 20 Years of Experience
Iulia Ciongradi1,2, Gabriel Aprodu1,2, Claudia Olaru1,2, Gabriela Ștefănescu1,3, Ileana Ioniuc1,2, Nicoleta Gimiga1,2, Magdalena Iorga1,2, Ioan Sârbu1,2* and Smaranda Diaconescu1,2
1“Gr.T.Popa” University of Medicine and Pharmacy, Iași, Romania
2“St. Mary” Emergency Hospital for Children, Iași, Romania
3“St. Spiridon” Emergency Hospital, Iași, Romania
- *Corresponding Author:
- Ioan Sârbu MD
"Gr.T.Popa" University of Medicine and
Iași, Romania 16, Universității Street, Romania
E-mail: [email protected]; [email protected]
Received Date: April 10, 2016; Accepted Date: May 20, 2016; Published Date: May 27, 2016
Citation: Ciongradi I, Aprodu G, Olaru C, Ștefănescu G, Ioniuc I, et al. Anorectal Malformations in a Tertiary Pediatric Surgery Center from Romania: 20 Years of Experience. Journal of Surgery [Jurnalul de chirurgie]. 2016; 12(2): 55-59 DOI:10.7438/1584-9341-12-2-3
Copyright: © 2016 Ciongradi I, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: The main goal of surgery and multidisciplinary behavioral therapy in anorectal malformations (ARMs) is to achieve good anatomical and functional outcomes and a better quality of life. Material and Methods: A retrospective analysis of 146 patients with ARMs was conducted over a 20 years period in our pediatric surgery department. The clinical and demographical data, operative protocols, short and long term outcomes were subject to assessment. Results: The patient series included 85 boys and 61 girls aged between one day and two years, of which 82.19% were diagnosed in the first few days of life by means of clinical examination and current imaging tests. In 26.02% of cases we found associated congenital abnormalities. A total of 142 (97.25%) cases of all our series underwent surgical treatment; four patients died before surgery. For 131 children the definitive treatment involved posterior sagittal anorectoplasty (PSARP) respectively 11 posterior sagittal anorectovaginourethroplasty (PSARVUP). Long-term followup in 115 patients showed good clinical continence in 82 cases (71.30%) but more than half of the teenagers had body dissatisfaction and social difficulties. Conclusions: Through this review of 20 years of experience our findings are consistent with other reports regarding male predominance, low birth weight, clinical and imaging diagnosis. We found however a lower incidence of associated abnormalities. The most frequent surgical intervention was posterior sagittal anorectoplasty (PSARP) or posterior sagittal anorectovaginourethroplasty (PSARVUP), both followed by satisfactory functional outcome reporting nevertheless moderate social insertion. Our experience in ARMs proved the effectiveness of the consecrated surgical strategy; long-term assistance for patients and their families should be improved.