Analysis of influencing factors on postoperative constipation in patients with Congenital Anorectal Malformations

Objective This study analyzed the clinical data of infants who underwent surgery for congenital anorectal malformations (ARM) and the factors influencing the occurrence of postoperative constipation. Methods This retrospective analysis was conducted using the clinical data of 177 infants with congenital ARM who had been diagnosed and operated on at the authors’ hospital from January 2008 to March 2018. This included 132 cases who underwent a perineal operation (PO), 23 cases of posterior sagittal anorectoplasty (PSARP), and 22 cases of laparoscopic-assisted anorectoplasty (LAARP). The patients were grouped according to clinical type, surgery mode, the presence of other malformations, the duration of surgery, the grade of wound healing, and the presence of ganglion cells at the blind end of the rectum. Results The constipation rate after surgery in patients of the intermediate/high type of ARM was higher than in low-type patients ( P  < 0.05). For surgery modes, the constipation rate in patients who underwent PO was higher than for those who received PSARP and LAARP ( P  < 0.05). The constipation rate of those with other malformations was higher than those without ( P  < 0.05). The constipation rate of those with Grade B and C wound healing was higher than in those with Grade A ( P  < 0.05). The constipation rate of those without ganglion cells at the blind end of the rectum was higher than in those with ganglion cells ( P  < 0.05). The clinical type (odds ratio [OR] 1.512, 95% confidence interval [CI], 1.301 and 3.551), operation mode (OR 1.586, 95% CI, 1.189 and 3.586), the presence of other malformations (OR 1.187, 95% CI 1.131 and 6.835), grade of wound healing (OR 1.234, 95% CI, 1.159 and 5.961), and the presence of ganglion cells at the blind end of the rectum (OR 1.215, 95% CI, 1.114 and 9.156) were found to be postoperative constipation influencing factors. Conclusions In infants who underwent surgery for congenital ARM, the clinical type, operation mode, the presence of other malformations, operation duration, wound healing grade, and the presence of ganglion cells at the blind end of the rectum were factors influencing postoperative constipation.