Long-Term Clinical and Physiological Outcomes in Patients Treated Non-Surgically for Anorectal Malformations

BackgroundWe aim to investigate the long-term clinical anorectal outcomes and anorectal physiology in patients treated non-surgically for minor types of anorectal malformations (ARM).MethodsWe retrospectively included 79 non-surgically treated patients born with minor types of ARM. We investigated constipation and fecal incontinence according to the Rome IV criteria, as well as anorectal physiology using anorectal manometry.Key ResultsOf all patients, 60% reported no constipation and no fecal incontinence, 38% experienced constipation, and 2% had fecal incontinence. All patients could contract the external anal sphincter and the puborectal muscle, both voluntarily and involuntarily, and 94% possessed a functional internal anal sphincter. The mean anal sensibility was 2.5 mA.Conclusions and InferencesThe long-term anorectal outcomes of non-surgically treated patients diagnosed with minor types of ARM seem optimal. Most of these patients experience no constipation and fecal incontinence; some experience constipation and relatively seldom fecal incontinence. Furthermore, most patients possess all the known fecal continence mechanisms. This study demonstrates that patients with minor ARM who received non-surgical treatment can achieve optimal anorectal function outcomes.