Outcomes in ARMs: Comparison Between Surgical Techniques in Patients With Perineal or Vestibular Fistula - a Multicenter Italian Study

This is a national, multicenter ambispective (retro-prospective) longitudinal cohort study. The study includes patients who underwent surgical correction between 2020 and 2027.

Data collected prior to study activation (2020-study start date) will be analyzed retrospectively from medical records, while patients enrolled after study activation will be followed prospectively with annual assessments until achievement of fecal continence or up to 6 years of age, whichever occurs first.

Anorectal malformations (ARM) are rare congenital anomalies requiring complex reconstructive surgery. Posterior sagittal anorectoplasty (PSARP) remains the gold standard; however, alternative techniques such as anterior sagittal anorectoplasty (ASARP) and transanal proctoplasty (TAP) are increasingly adopted.

This study aims to compare surgical techniques in terms of:

Fecal continence (Krickenbeck score)

Postoperative complications (Clavien-Madadi classification)

Quality of life (HAQL questionnaire)

Constipation and bowel management requirements

Time to continence achievement

Patients will be followed annually until 6 years of age or until continence is reached, whichever occurs first.

• Postoperative Complications Within 30 Days [Срок оценки: Within 30 days after surgical correction]
• ectal Mucosal Prolapse [Срок оценки: From surgery until 6 years of age or achievement of fecal continence (up to 6 years)]
• Quality of Life (HAQL Questionnaire) [Срок оценки: Assessed annually until 6 years of age or achievement of fecal continence]
• Constipation Severity and Bowel Management Requirements [Срок оценки: Assessed annually until 6 years of age or achievement of fecal continence]
• time to Achievement of Fecal Continence [Срок оценки: From date of surgery until continence is achieved or up to 6 years of age]