Purpose: The goal of this study was to determine the degree of consensus in the management of spinal cord tethering (TC) in patients with anorectal malformation (ARM) in a large cohort of European pediatric centers. Methods: A survey was sent to pediatric surgeons (one per center) members of the ARM-Net Consortium. Results: Twenty-four (86%) from ten different countries completed the survey. Overall prevalence of TC was: 21% unknown, 46% below 15, and 29% between 15 and 30%. Ninety-six agreed on screening all patients for TC regardless the type of ARM and 79% start screening at birth. Responses varied in TC definition and diagnostic tools. Fifty percent of respondents prefer ultrasound (US), 21% indicate either US or magnetic resonance (MRI) based on a pre-defined risk of presenting TC, and 21% perform both. Discrepancy exists in complementary test: 82% carry out urodynamic studies (UDS) and only 37% perform somatosensory-evoked potentials (SSEP). Prophylactic untethering is performed in only two centers (8%). Conclusions: Survey results support TC screening in all patients with ARM and conservative management of TC. There is discrepancy in the definition of TC, screening tools, and complementary test. Protocols should be developed to avoid such variability in management.
Tethered cord in patients affected by anorectal malformations: a survey from the ARM-Net Consortium / M. Fanjul, I. Samuk, P. Bagolan, E. Leva, C. Sloots, C. Gine, D. Aminoff, P. Midrio, I. De Blaauw, S. Deluggi, F. Fascetti Leon, A. Garcia, S. Giuliani, C. Grano, S. Grasshoff-Derr, M. Haanen, S. Holland-Cunz, E. Jenetzky, M. Lacher, G. Lisi, I. Makedonsky, C. Marcelis, M. Miserez, O. Ozen, F. Percin, H. Reutter, S. Rohleder, E. Schmiedeke, N. Schwarzer, P. Sloots, P. Stenstrom, H. Till, L. Van der Steeg, I. Van Rooij, P. Volk, T. Wester, N. Zwink. - In: PEDIATRIC SURGERY INTERNATIONAL. - ISSN 0179-0358. - 33:8(2017), pp. 849-854. [10.1007/s00383-017-4105-4]
Tethered cord in patients affected by anorectal malformations: a survey from the ARM-Net Consortium
E. Leva;
2017
Abstract
Purpose: The goal of this study was to determine the degree of consensus in the management of spinal cord tethering (TC) in patients with anorectal malformation (ARM) in a large cohort of European pediatric centers. Methods: A survey was sent to pediatric surgeons (one per center) members of the ARM-Net Consortium. Results: Twenty-four (86%) from ten different countries completed the survey. Overall prevalence of TC was: 21% unknown, 46% below 15, and 29% between 15 and 30%. Ninety-six agreed on screening all patients for TC regardless the type of ARM and 79% start screening at birth. Responses varied in TC definition and diagnostic tools. Fifty percent of respondents prefer ultrasound (US), 21% indicate either US or magnetic resonance (MRI) based on a pre-defined risk of presenting TC, and 21% perform both. Discrepancy exists in complementary test: 82% carry out urodynamic studies (UDS) and only 37% perform somatosensory-evoked potentials (SSEP). Prophylactic untethering is performed in only two centers (8%). Conclusions: Survey results support TC screening in all patients with ARM and conservative management of TC. There is discrepancy in the definition of TC, screening tools, and complementary test. Protocols should be developed to avoid such variability in management.
| File | Dimensione | Formato | |
|---|---|---|---|
|
1-s2.0-S0022346814000645-main.pdf
accesso riservato
Tipologia:
Publisher's version/PDF
Dimensione
182.77 kB
Formato
Adobe PDF
|
182.77 kB | Adobe PDF | Visualizza/Apri Richiedi una copia |
Pubblicazioni consigliate
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
