Anorectal Malformations: New Aspects Relevant to Adult Colorectal Surgeons

摘要

Anorectal malformations occur in approximately 1 in every 4,000 newborns, and pediatric surgeons care for the large majority of these patients. However, as these children grow to adulthood most of them suffer from different degrees of bowel malfunction or sequelae after surgical repair of their imperforate anus. Very few pediatric surgeons follow up these patients until they become adults. These patients seek help from gastroenterologists, general practitioners, or adult colorectal surgeons. This article was written for the community of colorectal surgeons who deal with patients who were born with anorectal malformations, underwent a surgical repair, and have different types of functional problems. Since 1982 the management of anorectal malformations has undergone a dramatic change with the advent of a new approach. This approach changed many of the traditional concepts related to this subject, including anatomy, classification, and surgical repair, and had a positive impact on clinical results. This new approach has been used systematically by this author in 785 consecutive cases. The analysis of this experience rendered significant lessons considered useful not only for pediatric surgeons in dealing with these patients during their early stages of life but also for adult colorectal surgeons.