Browsing by Author "Gobena Mormata"

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    Functional Outcomes of Anorectal Malformation: A 5 years Retrospective Study at Single institution, Ethiopia.
    (Addis Ababa Uinverstiy, 2025) Gobena Mormata; Abay Gosaye
    Anorectal malformation (ARM) is a wide spectrum of congenitalmalformation seen in pediatric patients. While the surgical techniques have advancedlong term functional outcomes like voluntary bowel movement, soiling andconstipations remain significant challenge for clinicians and patients especially in lowincome countries like Ethiopia. Objectives: To assess the functional outcomes of surgically reconstructed anorectalmalformations and identifying factors affecting the outcomes at single tertiaryinstitution in Ethiopia. Methodology: This is a retrospective cohort study which was conducted on 119children treated for ARM over a 5-year period from September 2018 to September2022. Functional outcomes was assessed using the Krickenbeck classification systems. Bivariate analysis was performed by using Chi-square, Fisher’s exact tests and Mann- Whitney U tests where they were appropriate according to the types of variables, thenfollowed by multivariable logistic regression to identify independent affecting factorswith Adjusted Odds Ratios [AOR] and 95% Confidence Intervals [CI]. Results: 84.9% of patients achieved VBM, while soiling and constipation were 47.1%and 24.4%, respectively. High ARM types were associated with higher soiling rates(77.8%; AOR 0.133, 95% CI: 0.031- 0.564, p=0.006). Conversely, low ARM typewas associated with constipation (43.5%; AOR 8.4, 95% CI: 1.48-47.66, p=0.016). Redo anoplasty was associated with poor VBM (AOR 0.1, 95% CI: 0.02-0.49, p=0.005) and increased soiling (AOR 0.128, 95% CI: 0.028-0.582, p=0.008). Whilethree-stage repairs showed higher soiling in bivariate analysis, multivariable analysisshowed no independent effect. Early age at definitive surgery was associated withbetter voluntary bowel movement (AOR 0.97, 95% CI: 0.93-0.99, p=0.024) Conclusion and Recommendation: A functional outcome of ARM patients aftersurgical reconstruction at TASH is comparable to international studies. Types ofARM, redo anoplasty and age at definitive surgery were identified as independentaffecting factors of the functional outcomes. However; neither stages of the surgerynor birth weight was independent affecting factor. So, the high rate of soiling needstructured postoperative bowel management and follow-up. Early definitive surgeryand decreasing of technical failures requiring reoperation are required for improvingfunctional outcomes.