Anorectal malformations: Early outcome analysis in a tertiary care center in India
Background: Delayed diagnosis, referral, and presence of associated anomalies may influence the outcome of Anorectal malformations (ARM). The aim of this study was to analyze the early outcomes (1 month postoperatively) of ARM presenting in the neonatal period. Methods: A prospective study was car...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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EL-Med-Pub
2021-05-01
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| Series: | Journal of Neonatal Surgery |
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| Online Access: | https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/927 |
| _version_ | 1818565311983517696 |
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| author | Priya Mathew Arun Kumar Gupta Rahul Gupta Dharmesh Sharma |
| author_facet | Priya Mathew Arun Kumar Gupta Rahul Gupta Dharmesh Sharma |
| author_sort | Priya Mathew |
| collection | DOAJ |
| description | Background: Delayed diagnosis, referral, and presence of associated anomalies may influence the outcome of Anorectal malformations (ARM). The aim of this study was to analyze the early outcomes (1 month postoperatively) of ARM presenting in the neonatal period.
Methods: A prospective study was carried out in our tertiary care teaching institute from December 2018 to March 2020. All neonates admitted in the NICU with ARM were studied.
Results: There were 315 neonates; out of these, 236 (74.92%) were male and 79 (25.07%) were female. High ARM (HARM) was present in 265 (84.13%) and low ARM (LARM) in 50 (15.87%). Associated congenital anomalies were noted in 121 (38.41%). Major associated anomalies consisted of gastrointestinal (GIT) (41.32%), oesophageal (31.4%), and genitourinary (GU) (19.83%). Out of 306 procedures for ARM, 196 (64.05%) neonates underwent left transverse colostomy (LTC). The most frequent postoperative complications were thrombocytopenia (115) followed by sepsis (98). Colostomy prolapse was uncommon (2). The overall mortality was 87/315 (27.61%) neonates - 82/265 (30.94%) in HARM and 5/50 (10%) in LARM. Neonatal mortality was significantly high with birth weight <2500gm 55/153 (35.94%; p value= 0.0001), associated malformations 82 (67.76%, p value= 0.003); and delayed presentation 40/87 (45%), and with primary perforation 5/6 (83.33%).
Conclusions: Higher mortality was associated with low birth weight, double/ triple atresia, neonatal GIT perforation, sepsis on admission, and those with oesophageal and cardiac anomalies. More than 1/3rd (38.41%) patients had associated anomalies; thus, a detailed systematic evaluation of all subtypes is paramount. |
| first_indexed | 2024-12-14T01:39:42Z |
| format | Article |
| id | doaj.art-ae84035b2f6048378f0346eb15a7cc17 |
| institution | Directory Open Access Journal |
| issn | 2226-0439 |
| language | English |
| last_indexed | 2024-12-14T01:39:42Z |
| publishDate | 2021-05-01 |
| publisher | EL-Med-Pub |
| record_format | Article |
| series | Journal of Neonatal Surgery |
| spelling | doaj.art-ae84035b2f6048378f0346eb15a7cc172022-12-21T23:21:47ZengEL-Med-PubJournal of Neonatal Surgery2226-04392021-05-011010.47338/jns.v10.927Anorectal malformations: Early outcome analysis in a tertiary care center in IndiaPriya Mathew0Arun Kumar Gupta1Rahul Gupta2Dharmesh Sharma3SMS Medical College, Jaipur, Rajasthan, IndiaDepartment of Pediatric Surgery, SMS Medical College, Jaipur, Rajasthan, IndiaDepartment of Pediatric Surgery, SMS Medical College, Jaipur, Rajasthan, IndiaDepartment of Preventive and Social Medicine, SMS Medical College, Jaipur, Rajasthan, IndiaBackground: Delayed diagnosis, referral, and presence of associated anomalies may influence the outcome of Anorectal malformations (ARM). The aim of this study was to analyze the early outcomes (1 month postoperatively) of ARM presenting in the neonatal period. Methods: A prospective study was carried out in our tertiary care teaching institute from December 2018 to March 2020. All neonates admitted in the NICU with ARM were studied. Results: There were 315 neonates; out of these, 236 (74.92%) were male and 79 (25.07%) were female. High ARM (HARM) was present in 265 (84.13%) and low ARM (LARM) in 50 (15.87%). Associated congenital anomalies were noted in 121 (38.41%). Major associated anomalies consisted of gastrointestinal (GIT) (41.32%), oesophageal (31.4%), and genitourinary (GU) (19.83%). Out of 306 procedures for ARM, 196 (64.05%) neonates underwent left transverse colostomy (LTC). The most frequent postoperative complications were thrombocytopenia (115) followed by sepsis (98). Colostomy prolapse was uncommon (2). The overall mortality was 87/315 (27.61%) neonates - 82/265 (30.94%) in HARM and 5/50 (10%) in LARM. Neonatal mortality was significantly high with birth weight <2500gm 55/153 (35.94%; p value= 0.0001), associated malformations 82 (67.76%, p value= 0.003); and delayed presentation 40/87 (45%), and with primary perforation 5/6 (83.33%). Conclusions: Higher mortality was associated with low birth weight, double/ triple atresia, neonatal GIT perforation, sepsis on admission, and those with oesophageal and cardiac anomalies. More than 1/3rd (38.41%) patients had associated anomalies; thus, a detailed systematic evaluation of all subtypes is paramount.https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/927Anorectal malformationAssociated anomaliesColostomyMortalityNeonatesOutcomes |
| spellingShingle | Priya Mathew Arun Kumar Gupta Rahul Gupta Dharmesh Sharma Anorectal malformations: Early outcome analysis in a tertiary care center in India Journal of Neonatal Surgery Anorectal malformation Associated anomalies Colostomy Mortality Neonates Outcomes |
| title | Anorectal malformations: Early outcome analysis in a tertiary care center in India |
| title_full | Anorectal malformations: Early outcome analysis in a tertiary care center in India |
| title_fullStr | Anorectal malformations: Early outcome analysis in a tertiary care center in India |
| title_full_unstemmed | Anorectal malformations: Early outcome analysis in a tertiary care center in India |
| title_short | Anorectal malformations: Early outcome analysis in a tertiary care center in India |
| title_sort | anorectal malformations early outcome analysis in a tertiary care center in india |
| topic | Anorectal malformation Associated anomalies Colostomy Mortality Neonates Outcomes |
| url | https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/927 |
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