Long Term Outcome of Bowel Function after Surgical Management of Anorectal Malformations at Mulago, Uganda
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Background: Anorectal Malformation (ARMs) is the commonest congenital anomaly seen at Paediatric Surgery Unit (PSU), Mulago Hospital, hence many patients undergo corrective Surgery for this condition. Knowledge about the long term outcomes of bowel function is essential to organize a structured follow up system to detect possible complications early. Objective: The aim of this study was to determine the long-term outcomes of bowel function after surgical management of ARMs at Mulago Hospital. Methods: A Retrospective Cohort Study was conducted on 99 participants 3-12 years of age who underwent surgical management for ARMs between January 2012 and June 2017 attending PSOPD, MNRH. The study focused on bowel functions using a scoring system derived from the Evaluation of fecal continence according to Rintala and Lindahl (1995). Patients were classified according to sum of their scores into four categories: poor (6–9); fair (9–11); good (12–17); and normal (18–20). Patients who had a redo PSARP, severe spina bifida and associated anomalies were excluded. Results: The Long Term Outcomes of Bowel Function: 65% Good (CI 27, 45), 35% Poor (55, 73) with soiling 49% (CI 40, 59); constipation 23% (CI 16, 32); and incontinence 39% (CI 30, 39). Conclusion: The long term outcomes of bowel function was found to be good. With improved follow up and timely management of complications, the outcomes can be ameliorated.