Anorectal Malformations

Anorectal malformations (ARMs) are rare birth defects of the digestive system affecting 2–6 per 10.000 births worldwide. These anomalies are the result of an abnormal development of the distal end of the digestive tract interesting the anus and/or rectum that occur early between the sixth and tenth week of embryonic development. ARMs are found as isolated congenital birth defects, as part of a syndrome or associated with other anomalies. Various classifications have been proposed to define the pathology of these anorectal anomalies. Almost all ARMs require surgery early in life. The spectrum of malformations sometimes mandates different techniques for different anomalies, but the preferred technique is also influenced by surgeon’s preference and surgical education. The most commonly used operative procedures for treatment of ARMs include perineal operations, posterior sagittal anorectoplasty, and laparoscopic abdominoperineal rectoplasty techniques. Cloacal anomaly requires highly specialized reconstructive surgery. Constipation and fecal incontinence are the most important functional disorders to avoid after definitive repair.