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Change over time in the postoperative defecation function in female patients with anovestibular fistula at a single institution: focus on the comparison of anal transposition with anterior sagittal anorectoplasty

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Abstract

Purpose

Anovestibular fistula (AVF) is the most common type of ARM in female patients. The present study investigated changes over time in the postoperative defecation function of female patients with AVF.

Methods

Patient data were collected from 1984 to 2021. Eighty-eight female patients with AVF were enrolled. Patients’ characteristics and the long-term outcome of defecation function were reviewed and analyzed retrospectively. The bowel function was evaluated according to the Japan Society of ARM Study Group evacuation score (ES).

Results

Thirty-eight patients underwent anal transposition (AT), and 8 underwent anterior sagittal anorectoplasty (ASARP). The total evacuation score (ES) in AVF patients reached “excellent” at nine years old, regardless of the operative procedure. The constipation scores with AT showed better improvement than those with ASARP, but soiling scores in the ASARP group showed better improvement than those in the AT group. The postoperative complications did not affect the postoperative bowel function in AVF patients.

Conclusion

Most patients with AVF eventually achieved a satisfactory total ES. Given the difference in defecation score transition depending on the operative procedure or postoperative complications, it may be important to perform long-term defecation management via surgical procedures.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Mr. Brian Quinn for his comments and help with the manuscript. This study was supported by the Research Project for Rare and Intractable Diseases of the Ministry of Health, Labour and Welfare (MHLW), a research grant from The Mother and Child Health Foundation, a research grant from the Kawano Masanori Memorial Public Interest Incorporated Foundation for Promotion of Pediatrics, and Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (JSPS: 22K07848, 22K08757, 22K12888, 22K15925, 22K08719, 22K07894, 22K02918, 22K08758, 22K02859, 21H00908, 21K12754, 21K08623, 21K07867, 20K08934, 20K17558, 20K10403, 20K08933, 20K21581, 20K22958), research grant from the Kawano Masanori Memorial Foundation for Promotion of Pediatrics and research grant from The Mother and Child Health Foundation.

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Author notes

  1. Ayaka Nagano and Toshio Harumatsu contributed equally to this work and shared first authorship.

Authors and Affiliations

  1. Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan

    Ayaka Nagano, Toshio Harumatsu, Koshiro Sugita, Yumiko Iwamoto, Masato Ogata, Lynne Takada, Nanako Nishida, Chihiro Kedoin, Masakazu Murakami, Keisuke Yano, Shun Onishi, Koji Yamada, Waka Yamada, Takafumi Kawano, Mitsuru Muto & Satoshi Ieiri

  2. Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan

    Tatsuru Kaji

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  1. Ayaka Nagano
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Contributions

AN, TH and KS: wrote the main manuscript text. SO, KY and NN: prepared tables and researched the literature. YI, MO, LT, CK, MM, KY, and WY: collected the data based on medical records. TK, MM and TK: gave conceptual advice. SI: critically reviewed the manuscript and supervised the whole collected data. All authors reviewed the manuscript.

Corresponding author

Correspondence to Satoshi Ieiri.

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The authors declare no conflicts of interest in association with the present study.

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Nagano, A., Harumatsu, T., Sugita, K. et al. Change over time in the postoperative defecation function in female patients with anovestibular fistula at a single institution: focus on the comparison of anal transposition with anterior sagittal anorectoplasty. Pediatr Surg Int 39, 266 (2023). https://doi.org/10.1007/s00383-023-05554-3

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