Prognostic factors for constipation following primary surgery of anorectal malformations in Yogyakarta, Indonesia
Abstract: Anorectal
Malformation (ARM) is a congenital malformation of the anorectal area, occur
approximately once in every 5000 live births. There are several morbidities
could occur after surgery in ARM. Constipation is the most common morbidity
post-surgery in ARM. This study was conducted to evaluate the prognostic
factors affecting constipation in postoperative anorectal malformation. This
was a case control study involving 74 children who undergo surgery in Dr.
Sardjito General Hospital, Yogyakarta from 2008 to 2012. The prognostic factors
are sex, type of ARM, age, type of ostomi, type of anoplasty operation,
dehiscence of anoplasty, and anal dilatation.
There were 41 (55.4%) male patients and 33 (44.6%) female patients in
this study. The risk of constipation in the patients with high level ARM was
lower than in low level ARM with an OR of 0.150 (95% CI=0.032 - 0.711;
p=0.008). Abdominoperineal pullthrough had higher risk for constipation than
non abdominoperineal pullthrough (PSARP and ASA) with p = 0.003. The
constipation rate was also different between patients with and without
dehiscence of anoplasty with an OR of 0.139 (95% CI=0.033 - 0.584; p=0.005).
The gender, types of colostomy, types of colon for colostomy, age of primary
operation, and frequency of anal dilatation did not affect the constipation
rate. In conclusion, postoperative constipation is still a major problem in
surgical for anorectal malformations in Yogyakarta. Types of anomaly, primary
operative procedures, and dehiscence of anoplasty operation are the prognostic
factors that affect the constipation in anorectal malformations.
Author: Willy Hardy Marpaung,
Rochadi
Journal Code: jpkedokterangg150352