Abstract
Purpose
ARM with perineal fistula has been traditionally defined as low ARM (LARM). This study was conducted to evaluate LARM in male patients with an emphasis on the role of various factors on the outcome and follow-up of them.
Materials and methods
It was a retrospective cohort study. The clinical presentation, associated anomalies, and complications were assessed. The operative procedures included cutback anoplasty and others. The patients were followed in the outpatient department. The complications were assessed and managed accordingly.
Results
During the study period of 8 years, 301 patients were admitted. The complaints included absent or abnormal anal opening, abdominal distension, constipation, and peritonitis. Most of the children (n = 214) presented in the neonatal period. The most common clinical presentation was the perineal fistula. The most common associated anomaly was urologic. Fourteen patients were referred from other centers after complications. The most common problem in follow-up was constipation.
Conclusion
LARM in male patients may have a diverse presentation. The associated anomalies need proper assessment. Awareness may avoid delayed presentation and unwanted complications. When managed by an expert, the condition can be effectively managed. Regular follow-up is important.
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GS and AP conceptualized the idea. GS, AK, NP, and AP performed the literature review and collected the data. AP, GS, and AK wrote the first draft of the manuscript. JR and NP reviewed the manuscript. AP and JR prepared the final draft. The final version was read and approved by all authors.
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The data of the present study were collected in the course of common clinical practice, and accordingly, the signed informed consent was obtained from each patient for any surgical and clinical procedure. The study protocol was in accordance with the ethical standards of the institutional research committee and the 1964 Helsinki Declaration and its later amendments. Because it was a retrospective study, formal consent for this study was not required, and no approval of the institutional research committee was needed.
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Shandilya, G., Pandey, A., Pant, N. et al. Evaluation and management of “low” anorectal malformation in male children: an observational study. Pediatr Surg Int 38, 337–343 (2022). https://doi.org/10.1007/s00383-021-05035-5
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DOI: https://doi.org/10.1007/s00383-021-05035-5