Rectal atresia and rectal stenosis: the ARM-Net Consortium experience

Pediatr Surg Int. 2023 Jul 28;39(1):242. doi: 10.1007/s00383-023-05518-7.

Abstract

Purpose: To assess the number, characteristics, and functional short-, and midterm outcomes of patients with rectal atresia (RA) and stenosis (RS) in the ARM-Net registry.

Methods: Patients with RA/RS were retrieved from the ARM-Net registry. Patient characteristics, associated anomalies, surgical approach, and functional bowel outcomes at 1 and 5-year follow-up were assessed.

Results: The ARM-Net registry included 2619 patients, of whom 36 (1.3%) had RA/RS. Median age at follow-up was 7.0 years (IQR 2.3-9.0). Twenty-three patients (63.9%, RA n = 13, RS n = 10) had additional anomalies. PSARP was the most performed reconstructive surgery for both RA (n = 9) and RS (n = 6) patients. At 1-year follow-up, 11/24 patients with known data (45.8%, RA n = 5, RS n = 6) were constipated, of whom 9 required stool softeners and/or laxatives. At 5-year follow-up, 8/9 patients with known data (88.9%, RA n = 4, RS n = 4) were constipated, all requiring laxatives and/or enema.

Conclusion: RA and RS are rare types of ARM, representing 1.3% of patients in the ARM-Net registry. Additional anomalies were present in majority of patients. Different surgical approaches were performed as reconstructive treatment, with constipation occurring in 46% and 89% of the patients at 1 and 5-year follow-up. However, accurate evaluation of long-term functional outcomes remains challenging.

Keywords: ARM-Net Consortium; Anorectal malformations; Constipation; Rectal atresia; Rectal stenosis.

MeSH terms

  • Anal Canal / abnormalities
  • Anorectal Malformations* / epidemiology
  • Anorectal Malformations* / surgery
  • Child
  • Child, Preschool
  • Constipation
  • Constriction, Pathologic / surgery
  • Humans
  • Laxatives
  • Rectal Diseases* / surgery
  • Rectum / abnormalities
  • Rectum / surgery
  • Retrospective Studies

Substances

  • Laxatives