Complications After Surgery for Anorectal Malformations: An ARM-Net consortium Registry Study
Makaleler > Tam Makale · 2025
Yazarlar: H.J.J. van der Steeg, I.C. Hageman, A. Morandi, E.E. Amerstorfer, C.E.J. Sloots, E. Jenetzky, P. Stenström, I. Samuk, M. Fanjul, P. Midrio, E. Schmiedeke, B.D. Iacobelli, I. de Blaauw, I.A.L.M. van Rooij, Dalia Aminoff, Piero Bagolan, Paul Broens, Yusuf Çavuşoğlu, Stefan Deluggi, Emre Divarci, Francesco Fascetti-Leon, Araceli García Vázquez, Carlos Giné, Stefano Giuliani, Ramon R. Gorter, Jan Gosemann, Martin Lacher, Caterina Grano, Sabine Grasshoff-Derr, Michel Haanen, Stefan Holland-Cunz, Wilfried Krois, Ernesto Leva, Judith Lindert, Gabriele Lisi, Johanna Ludwiczek, Igor Makedonsky, Carlo Marcelis, Chris Verhaak, Marc Miserez, Mazeena Mohideen, Alessio Pini Prato, Lucie Poš, Richard Škába, Carlos Reck-Burneo, Heiko Reutter, Stephan Rohleder, Nagoud Schukfeh, Nicole Schwarzer, Holger Till, Alejandra Vilanova-Sánchez, Patrick Volk, Marieke Witvliet
Journal of Pediatric Surgery, Uluslararası, Wos, 2025, cilt 60, ss 162403-162403
DOI: 10.1016/j.jpedsurg.2025.162403
Özet
OBJECTIVE: Establishing the incidence and types of complications following surgical intervention for ARM, primarily after reconstruction. Patient- and treatment-related risk factors were also determined. BACKGROUND: Postoperative complications of ARM surgery vary widely, with data predominantly derived from single-center retrospective studies with limited number of patients. Whether factors such as ARM type, associated congenital anomalies, prior enterostomy, or type of reconstructive surgery affect complication incidence remains unclear. METHODS: This multicenter cohort study was performed using the ARM-Net registry with prospectively collected data. Enterostomy-related and post-reconstructive complications in patients who underwent reconstructive surgery before the age of five years were recorded. Patients with more than 25 % missing data, unknown sex, ARM type, or reconstruction date, or without (information on) reconstruction or complications, were excluded. Multivariable analyses identified independent risk factors for the development of complications. RESULTS: A total of 2,043 patients were eligible for analysis. Complications after enterostomy formation and closure occurred in 25 % and 12 % of patients, respectively. Post-reconstructive complications occurred in 25 % of patients, with wound complications comprising half of the complications. In a multivariable analysis, recto-bladder neck fistula, any associated anomaly, and the LAARP procedure were identified as independent risk factors for post-reconstructive complications. In contrast, anoplasty and mini-PSARP reduce the risk of complications. CONCLUSIONS: Post-reconstructive complications in ARM patients are common, and certain patient- and treatment-related characteristics affect postoperative outcomes. These results aid counselling and clinical decision-making, and may guide the operative planning of ARM types that are amenable to several different surgical approaches.