Minimizing variance in pediatric patients after repair of anorectal malformations.

Leigh Selesner, Ryan Bigej, Sara Alturky, Cortnie Vaughn, Colin Gause, Sanjay Krishnaswami, Elizabeth Fialkowski

Abstract readMulticenter Study

In one paragraph

Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Leigh SelesnerDepart of Surgery, Oregon Health & Science University, Portland, OR, USA. selesner@ohsu.edu.

Ryan BigejSchool of Medicine, Oregon Health & Science University, Portland, OR, USA.

Sara AlturkySchool of Medicine, Oregon Health & Science University, Portland, OR, USA.

Cortnie VaughnDepart of Surgery, Oregon Health & Science University, Portland, OR, USA.

Colin GauseDepartment of Surgery, Division of Pediatric Surgery, Providence Health and Services, Portland, OR, USA.

Sanjay KrishnaswamiDivision of Pediatric Surgery, Oregon Health & Science University, Portland, OR, USA.

Elizabeth FialkowskiDivision of Pediatric Surgery, Oregon Health & Science University, Portland, OR, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeA standardized anorectal malformation (ARM) perioperative protocol was implemented across two pediatric tertiary hospitals. The protocol addressed antibiotic duration, feeding advancement, VACTERL workup, and wound management. We aim to evaluate complications, length of stay (LOS), and protocol compliance.

methodsIntroduced in June 2020, data from a 24-month protocol cohort (after a 6-month transition) were compared to a 24-month control cohort. Outcomes included demographics, compliance, complications and LOS.

resultsForty-five patients were included (control: 26, protocol: 19). Most were diagnosed with rectoperineal fistula (53%), 42% had significant cardiac disease, and 44% underwent prior colostomy. VACTERL workup was completed in 89%. Thirty-five patients underwent posterior sagittal anorectoplasty, and 10 cutback anoplasty. Median postoperative LOS was unchanged (control: 2 days; protocol: 2 days, p=0.80). Total LOS showed no difference (control: 3 days, protocol: 2 days, p = 0.51). No wound infections occurred. Wound dehiscence occurred in 1 control and 2 protocol patients (p=0.57). Compliance was 53% with deviations attributed to early diet initiation (n=4), incomplete VACTERL workup (n=2), and wound care (n=2).

conclusionA standardized ARM perioperative protocol is feasible across institutions. It maintained excellent outcomes, including short LOS and few complications, though the small sample limited statistical power.

Indexed as

Anal CanalAnorectal MalformationsPostoperative ComplicationsRectumChildChild, PreschoolFeasibility StudiesFemaleHumansInfantInfant, NewbornLength of StayMaleRetrospective StudiesAnorectal malformationPediatric surgeryPerioperative management protocolPosterior sagittal anorectoplastyQuality improvement

Identifiers

PMID40442369

DOI10.1007/s00383-025-06051-5

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.