{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T08:05:56Z","timestamp":1792137956804,"version":"4.4.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T00:00:00Z","timestamp":1677456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The need to search for ganglia in the terminal rectum\/fistula of complex anorectal malformations (ARMs) remains controversial. This study aims to evaluate the relationship between ganglia absence in the terminal rectum\/fistula and defecation function after anoplasty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of patients who received anoplasty for treating male imperforate anus with rectobulbar (RB)\/rectoprostatic (RP) fistulas at a tertiary pediatric hospital was conducted with registered demographic data, imaging study results, and information on the terminal rectum\/fistula specimen (excision extension and pathological findings). According to the pathological findings, patients were divided into Groups 1 (ganglia absence) and 2 (ganglia presence). Furthermore, the postoperative defecation function was evaluated using various rating scale questionnaires. Statistical analysis was performed using SPSS 22.0.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 62 patients, 18 (29.0%) showed ganglia absence in the terminal rectum\/fistula. By analyzing the imaging data, spinal anomalies and spinal cord anomalies were found in 30.6% (19\/62) and 56.5% (35\/62) of patients, respectively. Baseline information was comparable between Groups 1 and 2 (<jats:italic>P<\/jats:italic>\u2009&amp;gt;\u20090.05). For defecation function, there were no significant differences in Kelly scores between the two groups (4.0\u2009\u00b1\u20090.8 vs. 4.4\u2009\u00b1\u20091.1, <jats:italic>P<\/jats:italic>\u2009=\u20090.177), while Krickenbeck (3.7\u2009\u00b1\u20091.8 vs. 5.2\u2009\u00b1\u20091.4) and Rintala (13.7\u2009\u00b1\u20093.6 vs. 16.0\u2009\u00b1\u20092.7) scores in Group 1 were significantly lower than those in Group 2 (both <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05). The overall incidence of constipation was 50% (31\/62), being higher for Group 1 than Group 2 (77.5% vs. 38.6%, <jats:italic>P<\/jats:italic>\u2009=\u20090.002). The area under the curve of ganglia absence for predicting constipation was 0.696, with 77.8% sensitivity and 61.4% specificity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ganglia absence in the terminal rectum\/fistula of male imperforate anus with RB\/RP fistulas is associated with constipation after anoplasty, but it has limited predictive value for postoperative constipation. It is necessary to search for ganglia in the terminal rectum\/fistula, both intraoperatively and postoperatively.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2023.1124647","type":"journal-article","created":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T08:43:46Z","timestamp":1677055426000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Significance of searching for ganglia in the terminal rectum\/fistula of complex anorectal malformations: Related to defecation 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