Abstract
N.B. The malformations can be viewed in the PDF version of the poster.
Background:
Anorectal malformations (ARMs) are common congenital anomalies treated in various settings with or without intestinal diversion. While many ARM patients in high-income countries are treated with a one- or two-staged approach, the effectiveness of these approaches in low- and middle-income countries (LMICs) is not clear.
Aim
To review the literature on the management and outcomes of anorectal malformations in LMICs.Â
Methods
Several databases (Africa-Wide Information, Cochrane, Embase, Global Health, Global Index Medicus, Medline, Web of Science) were interrogated up to May 27, 2020, resulting in 1269 studies. Two independent authors reviewed and selected abstracts based on preset criteria. Data from included studies were extracted, analyzed, and summarized. Risk of bias was assessed using the Methodological Index for Non-Randomized Studies (MINORS).
Results
Sixty-five articles were included for full-text analysis. One could not be obtained, and 21 others were excluded after full-text analysis. Final included studies originated from 11 different LMICs. The most common high, intermediate, and low ARM types were rectovesical fistula (n=72), rectovestibular fistula (n=693), and anovestibular fistula (n=207) respectively. Eighteen studies reported single-stage correction, 10 reported multi-staged correction, and 15 studies compared the previous two. Most commonly performed procedures were anterior and posterior sagittal anorectoplasty. Most studies reported positive outcomes following single-stage correction of ARMs.ÌýÌýÌýÂ Â
Conclusion
The literature supports the effectiveness of single-stage correction for ARMs in LMICs. Further and multicenter studies are needed for single-stage repair for high ARMs.
