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Analysis of Associated Anomalies in Anorectal Malformation: Major and Minor Anomalies

Journal of Korean Medical Science 2020년 35권 14호 p.98 ~ 98
오채연 ( Oh Chae-Youn ) - Korea University College of Medicine Department of Surgery

윤중기 ( Youn Joong-Kee ) - Seoul National University Children’s Hospital Department of Pediatric Surgery
한지원 ( Han Ji-Won ) - Seoul National University Children’s Hospital Department of Pediatric Surgery
 ( Yang Hee-Beom ) - Seoul National University Children’s Hospital Department of Pediatric Surgery
김현영 ( Kim Hyun-Young ) - Seoul National University Children’s Hospital Department of Pediatric Surgery
정성은 ( Jung Sung-Eun ) - Seoul National University Children’s Hospital Department of Pediatric Surgery

Abstract


Background: Fifty to sixty percent of patients with anorectal malformation (ARM) have at least one associated anomaly (AA). We determined the incidence of AA with the subtypes of ARM classified in accordance with the Krickenbeck classification and analyzed differences in the incidence rates of major and minor AAs according to organ system.

Methods: From January 1999 to May 2017, we retrospectively analyzed congenital anomalies in patients who underwent an anoplasty for ARM at our institution. The AAs were divided into nine organ systems. To analyze the difference in the incidence of AAs, we calculated odds ratios (ORs) using cases of perineal fistula as the base group.

Results: Of the 460 patients, 256 (55.7%) were male, 299 (65%) had at least one anomaly, and 274 (59.6%) had major AAs. According to organ system, AAs were most common in the genitourinary (28%), cardiovascular (25%), and spinal/vertebral systems (22.6%). Major AA was most common in the cardiovascular (23%) and spinal/vertebral and genitourinary systems (19.3%). According to ARM subtype, AAs were common in the order of cloaca (93.9%), rectovaginal fistula (85.7%), and recto-bladder neck fistula (85%). For the incidence of AAs, cloaca (OR, 15.7) and recto-bladder neck fistula (OR, 5.74) showed significantly higher ORs. In the analysis of major AAs, the cloaca (OR, 19.77) showed the highest OR, followed by no fistula (OR, 4.78) and recto-bladder neck fistula (OR, 3.83).

Conclusion: A considerable number of patients with ARM had AAs. Our data are useful for predicting AAs in patients with ARM.

키워드

Anorectal Malformation; Imperforate Anus; Associated Anomaly; Organ System, Major Congenital Anomaly
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