ArticlePediatric surgery international2026
Anovestibular fistula versus other subtypes in female patients with low-type anorectal malformation: differential patterns in defecation function improvement and associated anomalies at a single institution.
Article in Pediatric surgery international, 2026. 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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Abstract
purposeTo investigate associated anomalies and the postoperative defecation function in female patients with low-type anorectal malformations (ARMs), focusing on comparing anovestibular fistula (AVF) with other subtypes.
methodsPatient data were collected between 1984 and 2021. Eighty-seven female patients with low-type ARMs were enrolled after excluding one undetermined case. Associated anomalies, operative procedures, and the long-term defecation function were analyzed and compared between the AVF and non-AVF groups.
resultsAVF was the most common subtype (52.9%), followed by anocutaneous fistula (21.8%), covered anal stenosis (11.5%), anovulvar fistula (10.3%), and covered anal complete (3.4%). Upper urinary tract anomalies and VACTERL association were significantly more frequent in AVF (17.4% and 13.0%) than in non-AVF. Specific associations were identified: trisomy 21 with covered anal complete (100%), perineal groove with anocutaneous fistula (10.5%), and MRKH syndrome with AVF (2.2%). Chronologically, non-AVF low-type ARMs achieved "excellent" evacuation scores at 6 years, whereas AVF patients typically achieved this by 9 years. Individual defecation parameters reached full scores by 7 years in all subtypes except AVF, where constipation persisted beyond 11 years.
conclusionThe postoperative defecation function in female patients with low-type ARMs demonstrates differential improvement patterns, with AVF requiring extended management until at least 9 years.
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