Bülent SÖNMEZ, Burhan BEGER
Van Medical Journal - 2026;33(3):255-261
Introduction: Anorectal malformations (ARM), including anal atresia, comprise a heterogeneous group of congenital anomalies associated with variable anatomical patterns, frequent associated anomalies, and long-term functional challenges. This study aimed to evaluate the demographic characteristics, associated anomalies, surgical management approaches, and early functional outcomes of patients with anal atresia treated in a single-center tertiary referral center. Materials and Methods: This retrospective single-center study included patients diagnosed with anal atresia and treated between January 2015 and January 2026. A total of 61 patients were screened, and 52 patients who met the inclusion criteria were included in the final analysis. Demographic characteristics, associated anomalies, surgical approaches, postoperative complications, and follow-up findings were retrospectively evaluated. All patients were classified according to the Krickenbeck classification system. Functional outcomes were assessed using Krickenbeck terminology-based bowel function parameters during postoperative follow-up. Results: Among the 52 included patients, 57.7% were male. Associated congenital anomalies were identified in 53.8% of patients, most commonly involving the genitourinary and renal systems. High-type malformations constituted 40.4% of cases, and fistulas were present in 73.1%. Staged surgical management was performed in 67.3% of patients, while posterior sagittal anorectoplasty (PSARP) was the predominant definitive surgical technique (88.5%). Early postoperative complications occurred in 17.3% of patients, most commonly surgical site infection. The mean follow-up duration was 10.8 +/- 2.3 months. Most patients demonstrated age-appropriate bowel function during follow-up, whereas persistent bowel dysfunction requiring structured bowel management was observed more frequently in patients with high-type malformations (p=XXX) and associated spinal anomalies (p=XXX). Conclusion: PSARP-based surgical management combined with multidisciplinary evaluation and structured postoperative follow-up was associated with acceptable early surgical and functional outcomes. However, because of the retrospective design and relatively short follow-up duration, the reported bowel function findings should be interpreted as preliminary early postoperative outcomes. Further prospective multicenter studies with longer follow-up are needed to better define long-term functional outcomes in ARM patients.
