Clinical Analysis Of 120 Cases Of Low Congenital Anorectal Manlformation

OBJECTIVE:To summarize the clinical characteristics of low congenital anorectal malformation, explore the accurate and valuable methods for diagnosis and treatment.METHODS:The 120 cases of children with low congenital anorectal malformation were collected in our hospital, and were reviewed retrospectively to analyze and summarize the clinical manifestations, diagnostic methods, associated anomalies, treatment and prognosis,RSULTS:(1)120 cases of children with congenital anorectal malformations were divided into low anorectal malformation without fistula, anorectal malformation with fistula, anal stenosis. The age for diagnosis of them werel±1.47 days,102.6±155.2 days,317.6±368.41 days respectively, and there were significant differences among the three groups (P<0.05). (2) There were 23 cases whose distance between the blind end of rectum to the anus were detected by the radiography and perineum ultrasound, and the distance were 19.83±16.21mm and9.39±3.65mm.Through statistical analysis, there were significant differences between the groups (P< 0.05).(3) Patients with anorectal malformations also were present with other associated defects, and the most common associated anomalies in our study was congenital cardiac abnormalies, and the incidence was 70.7%. The incidence of genitourinary abnormalies was 16.1%, and it of Gastrointestinal anomalies was 3.7%, and the incidence of spine anomalies was 5%. Morever, the incidence of congenital anorectal malformation with ASD, PDA, and VSD were 57.3%, 45.5% and 9.75%。By statistical analysis of their incidence,there was significant differences between ASD and VSD(P< 0.05), and PDA and VSD,.However, the incidence of ASD and PDA was no significant difference (P> 0.05).(4)110 children underwent transperineal anorectoplasty, who were cured after operation. Of the 64 cases with follow-up,4 cases (6.25%)didn’t had defecate consciousness,14 cases (21.87%) had constipation, and 3 patients (3.13%)had incontinence. According to domestic criteria classification for bowel function,59 cases were good,4 cases were medium and 1 case was poor.CONCLUSIONS:Clinical manifestations of anorectal malformation were associated with the malformation type and clinic time. For the anorectal malformation with fistula, the most important detective method is the perineum physical examination. For the anorectal malformation with no fistula, the radiography and perineum ultrasound examination are morevaluable. The accuracy which measured the distance between the blind end of rectum and anus of anorectal malformation with no fistula is significantly higher. The most common anomalies associated with low anorectal malformation is the congenital heart disease, then incidence of genitourinary abnormalities is lower. The transperineal anorectoplasty is the major surgery method, and patients after the operation should carry on the long-term follow-up, and get treatment for postoperative complications timely,which is important for preventing the postoperative bowel dysfunction.