Anorectal Malformations in a Tertiary Pediatric Surgery Center from Romania: 20 Years of Experience

Anorectal malformations (ARMs) are a group of commonly encountered congenital anomalies in pediatric surgery practice, with an incidence of 2 in 1000 to 1 in 5000 live births, but with significant variations between different regions throughout the world, as reported in the literature [1,2]. According to Peña and Bechit there is a wide spectrum of presentation, ranging from low perineal fistula to high anomalies with complex surgical management [3,4]. As Stoll and Moore discussed, ARMs are often associated with a complex range of another anomalies i.e. esophageal atresia, and central nervous system, cardiovascular, urogenital, gastrointestinal and skeletal defects [5,6]. In his report, Holschneider stated that the advances in imaging techniques and improvements in the knowledge of embryology, anatomy and physiology of ARM cases have refined both diagnosis and surgical therapy [7]. Other authors found that the classical approach to this pathology have moved towards PSARP and minimally invasive techniques with a clear goal of improving anatomical and functional outcomes and quality of life [8]. However constipation and fecal incontinence are still the main concerns regarding the long-term outcomes in these patients, as was discussed by de Blaauw et al. [9]