Results of transanal irrigation in intestinal dysfunction associated with anorectal malformations.

P L Roumieu, J Siffredi, V Di Benedetto, L Alvarez, M M Bailez
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Abstract

Introduction: There are multiple tools available to optimize defecation in patients with anorectal malformation (ARM), such as habits, laxatives, and retrograde or anterograde irrigations, which are usually adapted in a progressive and combined fashion. The objective of this study was to assess the incorporation of transanal irrigation (TAI) to constipation and fecal incontinence treatment in patients with ARM.

Materials and methods: A retrospective study of ARM patients with indication of TAI according to the colorectal pathology unit's intestinal management protocol from 2015 to 2022 was carried out. Following use for over 3 months, patients or their guardians completed a phone survey of our own approved by the ethics committee.

Results: 39 ARM patients participated in the study. Pathologies included 11 rectourethral fistulas, 6 rectovesical fistulas, 16 cloacae, 2 rectovaginal fistulas, 2 perineal fistulas, and 2 vestibular fistulas. 44% of them had a sacral index < 0.4. 62% had constipation, and 38% had incontinence. Thanks to TAI, confidence and safety improved in a very high and a high degree in 89% of the patients, whereas time devoted to intestinal management decreased a lot in 68% of them. 79% reported a 9- and 10-point quality-of-life improvement. 92% rated overall satisfaction with TAI with a score of 8, 9, and 10 - 10 meaning "completely satisfied." 100% recommend TAI.

Conclusion: TAI is a good alternative for the intestinal management of fecal incontinence and constipation.

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经肛门灌洗治疗与肛门直肠畸形有关的肠道功能障碍的结果。
导言:有多种工具可用于优化肛门直肠畸形(ARM)患者的排便,如习惯、泻药、逆行或逆行灌肠,这些工具通常以渐进和联合的方式进行调整。本研究的目的是评估经肛门灌洗(TAI)在治疗肛门畸形患者便秘和大便失禁中的应用情况:根据结直肠病理科的肠道管理方案,对2015年至2022年期间有TAI适应症的ARM患者进行了一项回顾性研究。在使用 3 个月以上后,患者或其监护人完成了一项经伦理委员会批准的电话调查:39 名 ARM 患者参与了研究。病理包括 11 个直肠尿道瘘、6 个直肠膀胱瘘、16 个泄殖腔瘘、2 个直肠阴道瘘、2 个会阴瘘和 2 个前庭瘘。其中 44% 有骶骨指数 结论:TAI 是肠道治疗大便失禁和便秘的良好选择。
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