# Risk factors for delayed extubation after pediatric perineal anaplasty in patients less than 1 year of age: a retrospective study

## TL;DR

This study identifies anesthesia method as a key factor in delayed extubation after anorectal malformation surgery in infants under one year old.

## Contribution

The study is the first to investigate risk factors for delayed extubation in infants undergoing anorectal malformation surgery.

## Key findings

- 60.2% of patients had normal intubation, while 39.8% experienced delayed extubation.
- Anesthesia method was independently associated with delayed extubation (P < 0.05).

## Abstract

Anorectal malformation is a common congenital problem occurring in 1 in 5,000 births and has a spectrum of anatomical presentations, requiring individualized surgical treatments for normal growth. Delayed extubation or reintubation may result in a longer intensive care unit (ICU) stay and hospital stay, increased mortality, prolonged duration of mechanical ventilation, increased tracheostomy rate, and higher hospital costs. Extensive studies have focused on the role of risk factors in early extubation during major infant surgery such as Cardiac surgery, neurosurgery, and liver surgery. However, no study has mentioned the influencing factors of delayed extubation in neonates and infants undergoing angioplasty surgery.

We performed a retrospective study of neonates and infants who underwent anorectal malformation surgery between June 2018 and June 2022. The principal goal of this study was to observe the incidence of delayed extubation in pediatric anorectal malformation surgery. The secondary goals were to identify the factors associated with delayed extubation in these infants.

We collected data describing 123 patients who had anorectal malformations from 2019 to 2022. It shows that 74(60.2%) in the normal intubation group and 49(39.8%) in the longer extubation. In the final model, anesthesia methods were independently associated with delayed extubation (P < 0.05).

We found that the anesthesia method was independently associated with early extubation in neonates and infants who accepted pediatric anorectal malformation surgery.