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Nagano A, Harumatsu T, Sugita K, Iwamoto Y, Ogata M, Takada L, Nishida N, Kedoin C, Murakami M, Yano K, Onishi S, Yamada K, Yamada W, Kawano T, Muto M, Kaji T, Ieiri S. Change over time in the postoperative defecation function in female patients with anovestibular fistula at a single institution: focus on the comparison of anal transposition with anterior sagittal anorectoplasty. Pediatr Surg Int 2023; 39:266. [PMID: 37673850 DOI: 10.1007/s00383-023-05554-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE Anovestibular fistula (AVF) is the most common type of ARM in female patients. The present study investigated changes over time in the postoperative defecation function of female patients with AVF. METHODS Patient data were collected from 1984 to 2021. Eighty-eight female patients with AVF were enrolled. Patients' characteristics and the long-term outcome of defecation function were reviewed and analyzed retrospectively. The bowel function was evaluated according to the Japan Society of ARM Study Group evacuation score (ES). RESULTS Thirty-eight patients underwent anal transposition (AT), and 8 underwent anterior sagittal anorectoplasty (ASARP). The total evacuation score (ES) in AVF patients reached "excellent" at nine years old, regardless of the operative procedure. The constipation scores with AT showed better improvement than those with ASARP, but soiling scores in the ASARP group showed better improvement than those in the AT group. The postoperative complications did not affect the postoperative bowel function in AVF patients. CONCLUSION Most patients with AVF eventually achieved a satisfactory total ES. Given the difference in defecation score transition depending on the operative procedure or postoperative complications, it may be important to perform long-term defecation management via surgical procedures.
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Affiliation(s)
- Ayaka Nagano
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Toshio Harumatsu
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Koshiro Sugita
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Yumiko Iwamoto
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Masato Ogata
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Lynne Takada
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Nanako Nishida
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Chihiro Kedoin
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Masakazu Murakami
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Keisuke Yano
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Shun Onishi
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Koji Yamada
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Waka Yamada
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Takafumi Kawano
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Mitsuru Muto
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Tatsuru Kaji
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Satoshi Ieiri
- Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan.
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