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Purpose <p>All patients born with anorectal malformations (ARMs) deserve high-quality healthcare, including appropriate neonatal screening, perioperative management, and long-term follow-up. This study examined global pediatric surgical practices for ARM management, identifying areas of consensus and variability in perioperative care and reported outcomes.</p> Methods <p>A multi-center survey distributed by The Hendren Project (a global networked community of pediatric surgeons) invited surgeons to retrospectively review their ten most recent primary ARM reconstructions, excluding reoperations. Data were compared by country/continent and World Bank income.</p> Results <p>A total of 144 surgeons from 90 hospitals in 50 countries reported outcomes for 900 patients. Sacral radiographs were inconsistently obtained, with 34.2% lacking lateral views and 21.9% missing anterior–posterior views. The complication rate after PSARP was 27.2%, including dehiscence (11.7%), wound infection (7.4%), and stricture (6.9%). Divided stomas were more common than loop colostomies (66.3% versus 28.8%). Postoperative anal dilations were performed by 92.6% of surgeons. Reported complication rates did not differ significantly by region or income category.</p> Conclusion <p>This global survey demonstrates wide regional and income-based variability in ARM perioperative care, spanning screening, operative strategy, timing, and postoperative management. Inconsistent sacral and spinal screening, especially in low-resource settings, highlights needs for standardized pathways and context-aware quality improvement efforts worldwide.</p>

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Pediatric surgical care of anorectal malformations: a global survey

  • 期刊论文

  • 发表日期：

    2026年7月8日

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  • Vatche Melkonian,
  • Sage A. Vincent,
  • Luis De la Torre,
  • Sara Ateeqa,
  • Mohamed Farag Baayou,
  • Adalberto Clemente Boca,
  • Isaac Chukwu,
  • Taiwo A. Lawal,
  • M. Oluwabukade T. Ojediran,
  • Abdullahi Koko Nuhu,
  • Nasiru Musa,
  • Omebe Sunday Egwu,
  • Obasi Akputa,
  • Gunduz Aghayev,
  • Muhammad Amjad Chaudhary,
  • Mansoor Ahmed,
  • Sadia Asmat Burki,
  • Muhammad Arshad,
  • Ayesha Saleem,
  • Muhammad Ali Shiekh,
  • Giulia Brisighelli,
  • Hansraj Mangray,
  • Yashlin Govender,
  • Aws Amjad Alhamdany,
  • Sarmad Zuheer Aldabbah,
  • Abouelkheir Anas,
  • Karla Santos-Jasso,
  • Noguez Castillo Monica,
  • Espinosa Becerra Jorge Rafael,
  • Bautista Martínez Maribel,
  • Aquino Hernández Jesús Orlando,
  • Bruno Martinez-Leo,
  • Ambriz-González,
  • Denisse Estefanía Alfaro Castellanos,
  • Guillermo Yanowsky Reyes,
  • Alfredo Domínguez-Muñoz,
  • Emilio Fernandez-Portilla,
  • Abhishek Kumar Singh,
  • Kanika Sharma,
  • Krishna Kumar Govindarajan,
  • Enono Yhoshu,
  • Mahendra Kumar Jangid,
  • Nahla Kechiche,
  • Mariem Beji,
  • Saloua Ammar,
  • Riadh Mhiri,
  • Ruta Vilija Dagilyte,
  • Gilvydas Verkauskas,
  • Arif Oktavian,
  • Supangat Supangat,
  • Ismael Essam Elhalaby,
  • Mahmoud Elfiky,
  • Heba Taher,
  • Judith Lindert,
  • Stefanie Maerzheuser,
  • Otto Hercules,
  • Mokrushina Olga,
  • Morozov Dmitriy,
  • Raphael Sun,
  • Erica Arnold,
  • Cortnie Vaughn,
  • Benjamin Carr,
  • Aodhnait S. Fahy,
  • Shauna Dowdrick,
  • Omar Nunez Lopez,
  • Shannon Castle,
  • Savannah C. Walker,
  • Lindsey L. Wolf,
  • Mathula Hettiarachchi,
  • Shireen Anne Nah Han Yien,
  • Don Evana Ezrien Binti Shaadon Zubir,
  • Mirko Bertozzi,
  • Giulia Fusi,
  • Anna Lavinia Bulotta,
  • Daniele Alberti,
  • Rajendran Ramaswamy,
  • Mutaz Ahmed,
  • Obada Alladh Alhallaq,
  • Lucas Koji Matsuzaki,
  • Sylvio Gilberto Andrade Avilla,
  • Fábio Antônio Perecim Volpe,
  • Wellen Cristina Canesin,
  • Joaquim Murray Bustorff-Silva,
  • Maria Giovana Oliveira Farias,
  • Auriane De Sousa Alencar,
  • Ivo Lima Viana,
  • Verónica Alonso,
  • Marta Ortega,
  • Laura Saura-García,
  • Clara Massaguer Bardají,
  • Julio César Moreno-Alfonso,
  • Alberto Pérez Martínez,
  • Roberto Antonio Martínez Quiroz,
  • Luis Enrique Sanchez-Sierra,
  • Caroll Yadira Alvarado Lemus,
  • Brenda Mercedes Hutton,
  • Amina G. Rasul,
  • Serdar Moralioglu,
  • Sabri Cansaran,
  • Aysenur Celayir,
  • Olga Devrim Ayvaz,
  • Vicente Aníbal Salinas-Salinas,
  • Jorge Alejandro Oliveros-Rivero,
  • Tipsuda Tangsriwong,
  • Chanel del Milagro Ugarte Coronel,
  • Jorge Luis Mehdi Garcíam Matias Berger,
  • Ximena Breden,
  • Celeste Patino Gonzalez,
  • Diego Sebastian Ruarte,
  • Luciano Sanz,
  • José Germán Jaramillo Samaniego,
  • Heidy Janet Tomas Huatuco,
  • Olga Elizarova Garay Bullón,
  • Wilbert Baca Carrasco,
  • Dora Sandra Cárdenas Hilasaca,
  • Hannah R. Neeser,
  • Sasha J. Tharakan,
  • Nebiyu Shitaye Aniley,
  • Etsub Abebaw,
  • Fossi Kamga Gacelle,
  • Mouafo Tambo Faustin Félicien,
  • Elena Hanganu,
  • Elvyn Alcantara,
  • Zaimy Diaz,
  • Nway Nway Thin Aung,
  • Felix Oyania,
  • Eunyoung Jung,
  • Anas Shikha,
  • Ayman A. A. Elhosny,
  • A. D. M. Shariful Islam,
  • Osnat Zmora,
  • Carolina Soares-Aquino,
  • Tiago Tuna,
  • Bourenane Haithem,
  • Zerizer Yassine,
  • Jorge Solarte-Henao,
  • Luis Mauricio Figueroa-Gutierrez,
  • Abdelrahman S. Elnour,
  • Abdelhakam Abuelbasher Yousif Abdalla,
  • Mohammed Haroon Ameen Basheer,
  • Agata Dzielendziak,
  • Dariusz Patkowski,
  • Luis De la Torre,
  • Kaitlin E. Olson,
  • Jill Ketzer,
  • Alberto Pena,
  • Andrea Bischoff

摘要

Purpose

All patients born with anorectal malformations (ARMs) deserve high-quality healthcare, including appropriate neonatal screening, perioperative management, and long-term follow-up. This study examined global pediatric surgical practices for ARM management, identifying areas of consensus and variability in perioperative care and reported outcomes.

Methods

A multi-center survey distributed by The Hendren Project (a global networked community of pediatric surgeons) invited surgeons to retrospectively review their ten most recent primary ARM reconstructions, excluding reoperations. Data were compared by country/continent and World Bank income.

Results

A total of 144 surgeons from 90 hospitals in 50 countries reported outcomes for 900 patients. Sacral radiographs were inconsistently obtained, with 34.2% lacking lateral views and 21.9% missing anterior–posterior views. The complication rate after PSARP was 27.2%, including dehiscence (11.7%), wound infection (7.4%), and stricture (6.9%). Divided stomas were more common than loop colostomies (66.3% versus 28.8%). Postoperative anal dilations were performed by 92.6% of surgeons. Reported complication rates did not differ significantly by region or income category.

Conclusion

This global survey demonstrates wide regional and income-based variability in ARM perioperative care, spanning screening, operative strategy, timing, and postoperative management. Inconsistent sacral and spinal screening, especially in low-resource settings, highlights needs for standardized pathways and context-aware quality improvement efforts worldwide.