SURGICAL APPROACHES TO ANORECTAL MALFORMATIONS AND THEIR OUTCOMES: AN INTEGRATIVE REVIEW

Anorectal malformations (ARM) are congenital conditions that affect the anatomy and function of the gastrointestinal tract, generating clinical complications that require surgical intervention. This study aims to critically review the current literature on the surgical techniques used in the management of MAR, comparing their clinical and functional results, as well as analyzing postoperative complications and associated genetic factors. The research follows a deductive method, based on an Integrative Literature Review (ILR) based on the PRISMA 2020 protocol, using the PICO strategy to guide the formulation of the research question and the selection of studies. To analyze the data, the Textual Discourse Analysis (TDA) methodology was used, as well as a Word Cloud Analysis, using NVivo software. The results indicate that the most frequently used surgical techniques are laparoscopic-assisted anorectoplasty (LAARP) and posterior sagittal anorectoplasty (PSARP). Both have been shown to be effective, with LAARP having aesthetic advantages, while PSARP is widely used for more complex malformations. Complications such as constipation and fecal incontinence have been observed in a significant proportion of patients, highlighting the importance of post-operative management. In addition, genetic variants, such as the CDX2 gene, were associated with more serious complications, reinforcing the relevance of genetic analysis in the treatment of MAR. We conclude that the choice of surgical technique should be personalized according to the patient's individual characteristics and the complexity of the malformation. It is suggested that future studies further investigate early interventions in low-resource settings and the inclusion of genetic analysis in clinical management to improve long-term outcomes.