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Purpose <p>Low-type anorectal malformation (LARM) is commonly associated with favorable fecal continence; however, some patients experience a suboptimal bowel function during early childhood. We evaluated whether the rectal pouch–perineum (P–P) distance, measured using preoperative ultrasonography, is associated with the postoperative bowel function.</p> Methods <p>Forty-seven children with LARMs who underwent surgery between 2006 and 2020 were analyzed over a 5-year follow-up. We measured the P–P distance on day 0/1 of life using transperineal ultrasonography. The bowel function at five years of age was assessed using the Japan Society of ARM Study Group evacuation score (ES). We conducted simple and multiple regression analyses to examine the association between the P and P distance and postoperative outcomes.</p> Results <p>A shorter P–P distance correlated with higher ES (B = − 0.833, <i>P</i> = 0.014), less soiling (B = − 0.282, <i>P</i> = 0.038), and less incontinence (B = − 0.357, <i>P</i> = 0.049). Lumbosacral malformations were independently associated with a lower ES, worse soiling, and urgency.</p> Conclusion <p>Ultrasonographic measurement of the P–P distance is useful for surgical planning and it is associated with the bowel function at 5 years of age in patients with LARMs. Although a shorter P–P distance was associated with a better bowel function in early childhood, a longer follow-up is required to determine whether P–P distance is associated with the ultimate long-term functional outcomes.</p>

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Association of preoperative ultrasonography with the bowel function at 5 years of age in low-type anorectal malformation: a retrospective cohort study

  • 期刊论文

  • 发表日期：

    2026年2月26日

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  • Shoichi Tsuzaka,
  • Kyoichi Deie,
  • Motoki Ebihara,
  • Rina Matsuda,
  • Takashi Tsutsuno,
  • Shotaro Taki,
  • Shoko Ogawa,
  • Yasuhiro Kondo,
  • Toshiko Takezoe,
  • Itsuki Naya,
  • Koichi Mizuta,
  • Takahiro Hosokawa,
  • Hiroshi Kawashima

摘要

Purpose

Low-type anorectal malformation (LARM) is commonly associated with favorable fecal continence; however, some patients experience a suboptimal bowel function during early childhood. We evaluated whether the rectal pouch–perineum (P–P) distance, measured using preoperative ultrasonography, is associated with the postoperative bowel function.

Methods

Forty-seven children with LARMs who underwent surgery between 2006 and 2020 were analyzed over a 5-year follow-up. We measured the P–P distance on day 0/1 of life using transperineal ultrasonography. The bowel function at five years of age was assessed using the Japan Society of ARM Study Group evacuation score (ES). We conducted simple and multiple regression analyses to examine the association between the P and P distance and postoperative outcomes.

Results

A shorter P–P distance correlated with higher ES (B = − 0.833, P = 0.014), less soiling (B = − 0.282, P = 0.038), and less incontinence (B = − 0.357, P = 0.049). Lumbosacral malformations were independently associated with a lower ES, worse soiling, and urgency.

Conclusion

Ultrasonographic measurement of the P–P distance is useful for surgical planning and it is associated with the bowel function at 5 years of age in patients with LARMs. Although a shorter P–P distance was associated with a better bowel function in early childhood, a longer follow-up is required to determine whether P–P distance is associated with the ultimate long-term functional outcomes.