Occurrence and influencing factors of defecation after anal plasty in children with congenital anorectal malformation

YAN Huan; ZHAO Jinliang; HUANG Hong; HU Wenli

Abstract：Objective To investigate the occurrence of fecal matter in patients with congenital anorectal malformations (ARMs) after anusoplasty and the influencing factors. Methods The clinical data of 108 children with ARMs admitted to chengdu women's and children's central hospital between December 2010 and June 2016 was analyzed retrospectively. The children were divided into the fecal pollution group (50 cases) and the non-fecal pollution group (58 cases) according to the occurrence of defecation after surgery. The age, sex, weight, complications, fistula, clinical types, number of times of anusoplasty, postoperative wound healing, and anal resuscitation were recorded and compared between the two groups. Correlation analysis was made of the difference of indexes. Results Univariate analysis of influencing factors of fecal contamination showed that significant difference was detected between the two groups in clinical classification, the number of times of operations, levels of wound healing, and complications (P<0.05). Logistic regression multivariate analysis of factors that influenced fecal pollution suggested that middle-high clinical types, anoplasty more than once, postoperative wound healing of grade B and C, and complications were independent risk factors for the occurrence of defecation after anal plasty in children with congenital anorectal malformations. Conclusion The incidence of incontinence after anusoplasty in children with ARMs is related to the clinical classification of patients, levels of postoperative wound healing, the number of times of anal angioplasty and complications. Early intervention in these factors can reduce the incidence of incontinence after anusoplasty in children with ARMs.