How much do we know about constipation after surgery for anorectal malformation?

Background: To evaluate the occurrence of constipation after anorectal malformations (ARM) repair and the results of laxative treatment. Methods: Between August 2012 and July 2017, the clinical data of patients with ARMs was prospectively collected. The patients were divided into two groups, good ty...

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Main Authors: Paul Chia-Yu Chang, Yih-Cherng Duh, Yu-Wei Fu, Yao-Jen Hsu, Chin-Hung Wei, Hsuan Huang
Format: Article
Language:English
Published: Elsevier 2020-02-01
Series:Pediatrics and Neonatology
Online Access:http://www.sciencedirect.com/science/article/pii/S1875957218307654
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author Paul Chia-Yu Chang
Yih-Cherng Duh
Yu-Wei Fu
Yao-Jen Hsu
Chin-Hung Wei
Hsuan Huang
author_facet Paul Chia-Yu Chang
Yih-Cherng Duh
Yu-Wei Fu
Yao-Jen Hsu
Chin-Hung Wei
Hsuan Huang
author_sort Paul Chia-Yu Chang
collection DOAJ
description Background: To evaluate the occurrence of constipation after anorectal malformations (ARM) repair and the results of laxative treatment. Methods: Between August 2012 and July 2017, the clinical data of patients with ARMs was prospectively collected. The patients were divided into two groups, good types and poor types. Good types included rectoperineal, rectovestibular, rectourethral bulbar, and no fistula. Risk factors were defined as spinal cord anomalies, sacral ratio <0.4, or cognitive impairment. Success was defined as that laxative could be tapered. Results: Eighty-four patients were enrolled with mean age of 6.3 ± 7.8 (0.6–59.9) years. The mean age of onset of constipation was 12.8 ± 8.3 months and the mean interval was 5.9 ± 5.1 months after reconstructions. The interval was not significantly different between patients with good types and poor types. In 23 patients with severe constipation being treated for >6 months, 14 of 18 (77.8%) patients with good types were classified as success, whereas only 1 of 5 (20%) patients with poor types was (p = 0.02). In patients with good types, 9 of 9 (100%) patients with no risk factors were successful; however, only 5 out of 9 (55.6%) patients with risk factors were successful (p = 0.02). Conclusion: Constipation occurs shortly after operations. Patients with good types and no risk factors are susceptible to weaning laxatives. Key Words: anorectal malformation, bowel function, constipation, laxative, megarectosigmoid
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spelling doaj-art-ad6ae5b8cfd04d0abcadf34ef370fd0d2025-08-20T03:52:07ZengElsevierPediatrics and Neonatology1875-95722020-02-01611586210.1016/j.pedneo.2019.05.010How much do we know about constipation after surgery for anorectal malformation?Paul Chia-Yu Chang0Yih-Cherng Duh1Yu-Wei Fu2Yao-Jen Hsu3Chin-Hung Wei4Hsuan Huang5Division of Pediatric Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan; School of Medicine, Mackay Medical College, New Taipei City, TaiwanDivision of Pediatric Surgery, Department of Surgery, Mackay Memorial Hospital, Hsinchu, TaiwanDepartment of Pediatric Surgery, Changhua Christian Hospital, Changhua, TaiwanDepartment of Pediatric Surgery, Changhua Christian Hospital, Changhua, TaiwanDivision of Pediatric Surgery, Department of Surgery, Shuang Ho Hospital, New Taipei City, Taiwan; Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Corresponding author. No. 291, Zhongzheng Rd., Zhonghe Dist., New Taipei City, 235, Taiwan.Division of Pediatric Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei, TaiwanBackground: To evaluate the occurrence of constipation after anorectal malformations (ARM) repair and the results of laxative treatment. Methods: Between August 2012 and July 2017, the clinical data of patients with ARMs was prospectively collected. The patients were divided into two groups, good types and poor types. Good types included rectoperineal, rectovestibular, rectourethral bulbar, and no fistula. Risk factors were defined as spinal cord anomalies, sacral ratio <0.4, or cognitive impairment. Success was defined as that laxative could be tapered. Results: Eighty-four patients were enrolled with mean age of 6.3 ± 7.8 (0.6–59.9) years. The mean age of onset of constipation was 12.8 ± 8.3 months and the mean interval was 5.9 ± 5.1 months after reconstructions. The interval was not significantly different between patients with good types and poor types. In 23 patients with severe constipation being treated for >6 months, 14 of 18 (77.8%) patients with good types were classified as success, whereas only 1 of 5 (20%) patients with poor types was (p = 0.02). In patients with good types, 9 of 9 (100%) patients with no risk factors were successful; however, only 5 out of 9 (55.6%) patients with risk factors were successful (p = 0.02). Conclusion: Constipation occurs shortly after operations. Patients with good types and no risk factors are susceptible to weaning laxatives. Key Words: anorectal malformation, bowel function, constipation, laxative, megarectosigmoidhttp://www.sciencedirect.com/science/article/pii/S1875957218307654
spellingShingle Paul Chia-Yu Chang
Yih-Cherng Duh
Yu-Wei Fu
Yao-Jen Hsu
Chin-Hung Wei
Hsuan Huang
How much do we know about constipation after surgery for anorectal malformation?
Pediatrics and Neonatology
title How much do we know about constipation after surgery for anorectal malformation?
title_full How much do we know about constipation after surgery for anorectal malformation?
title_fullStr How much do we know about constipation after surgery for anorectal malformation?
title_full_unstemmed How much do we know about constipation after surgery for anorectal malformation?
title_short How much do we know about constipation after surgery for anorectal malformation?
title_sort how much do we know about constipation after surgery for anorectal malformation
url http://www.sciencedirect.com/science/article/pii/S1875957218307654
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