A single-center retrospective study of the surgery outcome of Megarectosigmoid (MRS) after anorectal malformation (ARM) repair

Background The Megarectosigmoid (MRS) after anorectal malformation (ARM) repair can have a negative impact on the pediatric quality of life. However, current treatments lack consensus due to variable efficacy. Objective To evaluate the long-term outcome of laparoscopic-assisted MRS resection (resection of the dilated sigmoid colon and rectum) with anal reconstruction (LAMR-AR) and provide the indications to surgical treatment for MRS. Methods A retrospective cohort analyzed 49 pediatric MRS patients, who all had underwent ARM repair before LAMR-AR. Clinical data included imaging and surgical parameters. Patients were stratified by anal morphology: normal anus group (NAG) vs abnormal anus group (AAG) (stenosis/ectopic anus). Functional outcomes were assessed via Rintala scores (R-score) and Krickenbeck criteria for soiling/constipation. Results This study enrolled a cohort of 49 pediatric patients (28 males, 21 females) with a median age of 2.75 years (interquartile range [IQR]: 1.42–3 years). Postoperatively, in normal anus group, constipation decreased from 92.9%(26/28 grade3:26) to 7.1%(2/28 grade2:1 grade3:1)( p