Clinical analysis for associated congenital anomalies in congenital complex anorectal malformation

Min ZHANG; Jing SUN; Zhili WANG; Chengchao GU; Xiaoqing LI; Siqi HONG; Yi WANG

doi:10.16016/j.1000-5404.201802036

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Clinical analysis for associated congenital anomalies in congenital complex anorectal malformation

更新时间：2026-01-09

- Clinical analysis for associated congenital anomalies in congenital complex anorectal malformation
- Journal of Third Military Medical University Vol. 40, Issue 17, Pages: 1590-1594(2018)
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.201802036
  CLC：
- Received：05 February 2018，
  
  Published：15 September 2018
- 稿件说明：
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Min ZHANG, Jing SUN, Zhili WANG, et al. Clinical analysis for associated congenital anomalies in congenital complex anorectal malformation[J]. Journal of Third Military Medical University, 2018, 40(17): 1590-1594.
DOI：

Min ZHANG, Jing SUN, Zhili WANG, et al. Clinical analysis for associated congenital anomalies in congenital complex anorectal malformation[J]. Journal of Third Military Medical University, 2018, 40(17): 1590-1594. DOI： 10.16016/j.1000-5404.201802036.

摘要

Abstract

Objective

To investigate and summarize the congenital anomalies associated with congenital complex anorectal malformation (ARM) so as to provide the reference for the prognosis evaluation and treatment of the congenital complex ARM children.

Methods

A retrospective study was carried out on 105 children with the congenital complex ARM undergoing staged surgical treatment in our department from January 2012 to December 2015. They were 76 males and 29 females

and freshly diagnosed in 1 to 345 d (median age 2 d) after birth. The pathological types of ARM

associated congenital anomalies and clinical outcomes were collected and analyzed.

Results

① Among the 105 enrolled subjects

103 cases had at least one associated malformation (98.10%)

including 95.35% of cardiac structural deformity (82/86 with freshly echocardiographic diagnosis)

56.19% of genitourinary system malformations (59/105)

29.3% of spinal cord deformities (22/75) and 16.19% of skeletal deformities (17/105). ② For the 86 children with echocardiographic diagnosis for the first time

there were 82 identified

including 44 cases of patent ductus arteriosus (PDA

53.66%)

12 cases of ventricular septal defect (VSD

14.63%) and 45 cases of atrial septal defect (ASD

54.88%). There were still 24 cases with malformations in 6 to 9 months after first-stage surgery. The self-healing rate for PDA

VSD and ASD was 95.45%

41.67% and 66.67%

respectively

with statistical differences in the rate (

0.05). There was no statistical difference in the size of defect in cardiac structural deformity between those with total self-healing of cardiac structural deformity and those without (

0.05). ③ Physical examination and urological ultrasound imaging showed that there were 59 cases with malformations in urinary system among the 105 patients

including 7 cases of hydronephrosis (

10 mm)

7 cases of unilateral renal agenesis

3 cases of fused kidney

6 cases of unilateral renal dysplasia

(10.17%)

and 9 cases of hypospadias (15.25%). And 4 cases of hydronephrosis were recovered in 6 to 9 months after first-stage surgery. ④ There were no significant differences in cardiac structural malformations and combined system malformations between those belonging to high (supralevator) and those to intermediate (partially translevator) and low (translevator) ARMs groups according to Wingspread classification and Wingspread classification (

0.05).

Conclusion

Congenital ARM children are prone to accompany with multiple system malformations

with heart structural malformations most common. Some simple associated malformations have a tendency of self-healing

and they should be closely followed up. For some complex cardiac malformations

such as severe hydronephrosis

tethered cord and other serious complications

close follow-up and timely intervention therapy should be given in clinical practice.

关键词

Keywords

references

WOOD R J LEVITT M A Anorectal malformations Clin Colon Rectal Surg 2018 31 2 61 70 10.1055/s-0037-1609020 WOOD R J, LEVITT M A. Anorectal malformations[J]. Clin Colon Rectal Surg, 2018, 31(2): 61-70. DOI:10.1055/s-0037-1609020.

RINTALA R J Congenital anorectal malformations: anything new? J Pediatr Gastroenterol Nutr 2009 48 Suppl 2 S79 S82 10.1097/MPG.0b013e3181a15b5e RINTALA R J. Congenital anorectal malformations: anything new?[J]. J Pediatr Gastroenterol Nutr, 2009, 48(Suppl 2): S79-S82. DOI:10.1097/MPG.0b013e3181a15b5e.

蔡威孙宁魏光辉小儿外科学 5版北京人民卫生出版社 2014 351 352 蔡威, 孙宁, 魏光辉.小儿外科学[M]. 5版.北京:人民卫生出版社, 2014:351-352.

CAI W SUN N WEI G H Pediatric surgery 5th ed Beijing People's Medical Publishing House 2014 351 352 CAI W, SUN N, WEI G H. Pediatric surgery[M]. 5th ed. Beijing: People's Medical Publishing House, 2014:351-352.

KOVACIC K MATTA S R KOVACIC K Healthcare utilization and comorbidities associated with anorectal malformations in the United States J Pediatr 2018 194 142 146 10.1016/j.jpeds.2017.10.010 KOVACIC K, MATTA S R, KOVACIC K, et al. Healthcare utilization and comorbidities associated with anorectal malformations in the United States[J]. J Pediatr, 2018, 194: 142-146. DOI:10.1016/j.jpeds.2017.10.010.

TORRES R LEVITT M A TOVILLA J M Anorectal malformations and Down's syndrome J Pediatr Surg 1998 33 2 194 197 10.1016/s0022-3468(98)90430-4 TORRES R, LEVITT M A, TOVILLA J M, et al. Anorectal malformations and Down's syndrome[J]. J Pediatr Surg, 1998, 33(2): 194-197. DOI:10.1016/s0022-3468(98)90430-4.

GOOSSENS W J DE BLAAUW I WIJNEN M H Urological anomalies in anorectal malformations in The Nethe-rlands: effects of screening all patients on long-term outcome Pediatr Surg Int 2011 27 10 1091 1097 10.1007/s00383-011-2959-4 GOOSSENS W J, DE BLAAUW I, WIJNEN M H, et al. Urological anomalies in anorectal malformations in The Nethe-rlands: effects of screening all patients on long-term outcome[J]. Pediatr Surg Int, 2011, 27(10): 1091-1097. DOI:10.1007/s00383-011-2959-4.

JONKER J E LIEM E T ELZENGA N J Congenital anorectal malformation severity does not predict severity of congenital heart defects J Pediatr 2016 179 150 153 10.1016/j.jpeds.2016.08.047 JONKER J E, LIEM E T, ELZENGA N J, et al. Congenital anorectal malformation severity does not predict severity of congenital heart defects[J]. J Pediatr, 2016, 179: 150-153.e1. DOI:10.1016/j.jpeds.2016.08.047.

许海华徐国栋张富义男性儿童尿道下裂与先天性直肠肛门畸形的关联性广东医学 2015 36 14 2202 2204 http://d.old.wanfangdata.com.cn/Periodical/gdyx201514028 许海华, 徐国栋, 张富义, 等.男性儿童尿道下裂与先天性直肠肛门畸形的关联性[J].广东医学, 2015, 36(14): 2202-2204.

XU H H XU G D ZHANG F Y Association between hypospadias and congenital anorectal malformations in male children Guangdong Med J 2015 36 14 2202 2204 http://d.old.wanfangdata.com.cn/Periodical/gdyx201514028 XU H H, XU G D, ZHANG F Y, et al. Association between hypospadias and congenital anorectal malformations in male children[J].Guangdong Med J, 2015, 36(14): 2202-2204.

HOLSCHNEIDER A HUTSON J PEÑA A Preliminary report on the International Conference for the Development of Standards for the Treatment of Anorectal Malformations J Pediatr Surg 2005 40 10 1521 1526 10.1016/j.jpedsurg.2005.08.002 HOLSCHNEIDER A, HUTSON J, PEÑA A, et al. Preliminary report on the International Conference for the Development of Standards for the Treatment of Anorectal Malformations[J]. J Pediatr Surg, 2005, 40(10): 1521-1526. DOI:10.1016/j.jpedsurg.2005.08.002.

FALCONE R A JR LEVITT M A PEÑA A Increased heritability of certain types of anorectal malformations J Pediatr Surg 2007 42 1 124 127 10.1016/j.jpedsurg.2006.09.012 FALCONE R A JR, LEVITT M A, PEÑA A, et al. Increased heritability of certain types of anorectal malformations[J]. J Pediatr Surg, 2007, 42(1): 124-127. DOI:10.1016/j.jpedsurg.2006.09.012.

SARKAR A AL SHANAFEY S MOURAD M No-fistula vs. fistula type anorectal malformation: Outcome comparative study J Pediatr Surg 2018 [Epub ahead of print] 10.1016/j.jpedsurg.2018.03.014 SARKAR A, AL SHANAFEY S, MOURAD M, et al. No-fistula vs. fistula type anorectal malformation: Outcome comparative study[J]. J Pediatr Surg, 2018.[Epub ahead of print].DOI:10.1016/j.jpedsurg.2018.03.014.

ENDO M HAYASHI A ISHIHARA M Analysis of 1, 992 patients with anorectal malformations over the past two decades in Japan. Steering Committee of Japanese Study Group of Anorectal Anomalies J Pediatr Surg 1999 34 3 435 441 10.1016/s0022-3468(99)90494-3 ENDO M, HAYASHI A, ISHIHARA M, et al. Analysis of 1, 992 patients with anorectal malformations over the past two decades in Japan. Steering Committee of Japanese Study Group of Anorectal Anomalies[J]. J Pediatr Surg, 1999, 34(3): 435-441. DOI:10.1016/s0022-3468(99)90494-3.

CHO S MOORE S P FANGMAN T One hundred three consecutive patients with anorectal malformations and their associated anomalies Arch Pediatr Adolesc Med 2001 155 5 587 591 10.1001/archpedi.155.5.587 CHO S, MOORE S P, FANGMAN T. One hundred three consecutive patients with anorectal malformations and their associated anomalies[J]. Arch Pediatr Adolesc Med, 2001, 155(5): 587-591.DOI:10.1001/archpedi.155.5.587.

TSUDA T IWAI N KIMURA O Bowel function after surgery for anorectal malformations in patients with tethered spinal cord Pediatr Surg Int 2007 23 12 1171 1174 10.1007/s00383-007-2025-4 TSUDA T, IWAI N, KIMURA O, et al. Bowel function after surgery for anorectal malformations in patients with tethered spinal cord[J]. Pediatr Surg Int, 2007, 23(12): 1171-1174. DOI:10.1007/s00383-007-2025-4.

DESTRO F CANAZZA L MERONI M Tethered cord and anorectal malformations: a case series Eur J Pediatr Surg 2017 [Epub ahead of print] 10.1055/s-0037-1606844 DESTRO F, CANAZZA L, MERONI M, et al. Tethered cord and anorectal malformations: a case series[J]. Eur J Pediatr Surg, 2017.[Epub ahead of print]. DOI: 10.1055/s-0037-1606844.

XU W LI H HUANG X Multi-disciplinary collaborative therapeutic strategies to children with congenital anorectal malformations J Jpn Soc Pediatr Surg 2012 48 1 149 150 http://ci.nii.ac.jp/lognavi?name=nels&lang=jp&type=pdf&id=ART0009916668 XU W, LI H, HUANG X, et al. Multi-disciplinary collaborative therapeutic strategies to children with congenital anorectal malformations[J]. J Jpn Soc Pediatr Surg, 2012, 48(1): 149-150.

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