Worldwide paediatric surgical practice regarding post-reconstruction anal dilatation in anorectal malformation: an international survey.

PURPOSE: To assess current worldwide practice regarding routine post-operative dilatations (RPD) following reconstruction for ARM. To determine whether surgeons would consider participating in a prospective study or randomised controlled trial (RCT) comparing RPD versus no RPD. METHODS: We circulated a Google forms survey to members of the European Paediatric Surgical Association (EUPSA), United Kingdom Paediatric Colorectal Group (UKPCG), delegates at the 2022 EUPSA international congress and the 2022 Simpson Smith Symposium. We recorded the name and country of responding surgeons; the volume of cases managed and the practice of RPD. Surgeons were asked if they would be willing to change their local protocols and enter patients into a RCT. RESULTS: We received 134 responses from 114 centres in 48 countries across 5 continents. One hundred and five (92%) centres performed RPD on all patients; 2 (2%) centres performed RPD based on surgeon preference; 7 (6%) centres did not perform RPD. 71 surgeons (60%) stated they would be willing to change their local protocol for the purposes of a RCT. CONCLUSIONS: The vast majority of centres perform RPD following reconstruction for ARM. However, there appears to be increased interest in participation in a RCT to compare dilatations versus no dilatations.