CLINICAL SIGNIFICANCE OF SURGICAL INTERVENTION IN CHILDREN WITH ANORECTAL MALFORMATIONS

Abstract

Anorectal malformations (ARM) are among the most clinically important congenital anomalies in pediatric coloproctology. Their surgical correction is aimed not only at restoration of intestinal continuity and formation of an anatomically correct anus, but also at prevention of obstruction, reduction of postoperative complications and improvement of long-term bowel function. The clinical value of surgery depends on timely diagnosis, precise classification of the defect, detection of associated congenital anomalies and correct selection of a staged or one-stage operative approach. This study presents the experience of surgical treatment of 56 children with ARM treated at the Republican Scientific and Practical Center for Pediatric Minimally Invasive and Endoscopic Surgery, Tashkent, Uzbekistan. The patients were evaluated using clinical, laboratory and instrumental diagnostic methods, including radiography, ultrasonography, contrast studies, echocardiography, neurosonography and specialist consultations when indicated. The novelty of this thesis is the emphasis on surgical intervention as a complex clinical process that includes preoperative risk assessment, individual choice of operative tactics and postoperative functional monitoring. The results showed that early diagnosis, correct anatomical evaluation and planned surgical correction were associated with safer treatment, lower risk of severe complications and better functional outcomes. Staged treatment was particularly important in high and complex forms of ARM, while low forms required accurate reconstruction with preservation of the sphincter complex. Long-term rehabilitation and dispensary follow-up were essential for improving continence, preventing constipation and maintaining quality of life.