Early definitive operation for patients with anorectal malformation was associated with a better long-term postoperative bowel function
Early definitive operation for patients with anorectal malformation was associated with a better long-term postoperative bowel function
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DOI：
10.1007/s00383-020-04842-6
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发表时间：
2021-01-25
影响因子：
1.8
通讯作者：
Ieiri, Satoshi
中科院分区：
文献类型：
--
作者：
Harumatsu, Toshio;Kaji, Tatsuru;Ieiri, Satoshi
目的：在日本，肛门直肠畸形(ARM)患者一般在6个月左右接受手术治疗。我们的目的是阐明最终手术的时机是否会影响长期的肠功能。方法收集1984~2007年间住院患者资料。入选52例男性高中型上肢患者。根据患者的手术时间分为两组：早期组(EG)在出生后5个月接受肛门直肠成形术(n=22)，晚期组(LG)在出生后5个月接受肛门直肠成形术(n=30)。在3岁、5岁、7岁、9岁和11岁时使用日本肛门直肠畸形学会研究小组的排便评分(ES)来评估肠道功能。结果随着年龄的增长，患者的总分和4项功能结果均有不同程度的提高。与LG组相比，EG组的便秘评分明显改善。在11岁时，实验组儿童的总分和大小便失禁评分均显著高于对照组。结论观察组远期排便功能优于对照组。早期肛门直肠成形术对于ARM患者术后获得更好的肠功能非常重要。
Purpose In general, patients with anorectal malformation (ARM) undergo surgical treatment at around 6 months of age in Japan. We aimed to clarify whether the timing of a definitive operation affects the long-term bowel function. Methods Patient data were collected from 1984 to 2007. Fifty-two male patients with high- and intermediate-type ARM were enrolled. Patients were classified into two groups based on their operative period: the early group (EG) underwent anorectoplasty at < 5 months of age (n = 22); the late group (LG) underwent anorectoplasty at >= 5 months (n = 30). The bowel function was evaluated at 3, 5, 7, 9, and 11 years of age using the evacuation score (ES) of the Japan Society of Anorectal Malformation Study Group. Results The total score and four functional outcomes improved chronologically with age. The constipation score in the EG showed significantly better improvement in comparison to the LG. The total score and the incontinence score in the EG were significantly higher than those in the LG at 11 years of age. Conclusion The long-term bowel function in the EG was better than that in the LG. Anorectoplasty at an early age was important for achieving a better postoperative bowel function in ARM patients.