Purpose: To evaluate bowel function in patients with anorectal malformations (ARM) comparing existing scoring systems. Methods: Parents of ARM patients treated at our institution were asked to fill in Holschneider, Kricknebeck, and Rintala questionnaires. Scores obtained from the questionnaires were expressed per cent and analyzed depending on the age and type of ARM according to Krickenbeck classification. Patients younger than 3 years of age or with developmental delay were excluded. Results: Eighty patients (42 males: 52%) were included. Median age was 7.6 years (range 3–22). Twenty eight patients (35%) had perineal fistula, 13 (16%) bulbar, 7 (9%) prostatic, 5 (6%) rectobladder neck, 15 (19%) vestibular, 7 (9%) had a cloaca and 5 (6%) imperforate anus without fistula. Using Holschneider, Krickenbeck, and Rintala, average scores were respectively 72, 71 and 73 (p = 0.4 with ANOVA). Using the three questionnaires patients with perineal fistula scored 82, 76 and 84 respectively (p = 0.003), with bulbar 70, 71, 73 (p = 0.8), with prostatic 52,69,59 (p = 0.06), with bladder neck 56, 80, 57 (p = 0.004), with vestibular 75,67,75 (p = 0.02), with cloaca 64, 67, 65 (p = 0.9), and with imperforate anus without fistula 61,49, 53 (p = 0.12). Patients from 3 to 6 years of age scored 74,72 and 76 (p = 0.37), from 7 to 12: 70,71 and 71 (p = 0.87), and older than twelve: 74,66 e 73 (p = 0.08). Conclusion: The scores obtained using Holschneider, Rintala, and Krickenbeck questionnaires are significantly lower with increasing severity of the ARM. For each type of ARM there are some differences in the results obtained using the three questionnaires. In general, Krickenbeck and Peña questionnaires tend to give lower scores in patients with ARMs that have good prognosis, and higher scores for ARMs with poor prognosis. Age is not significantly related to the score obtained. Level of evidence: III Type of study: Diagnostic study

Continence after posterior sagittal anorectoplasty for anorectal malformations: comparison of different scores / G. Brisighelli, F. Macchini, D. Consonni, A. Di Cesare, A. Morandi, E. Leva. - In: JOURNAL OF PEDIATRIC SURGERY. - ISSN 0022-3468. - 53:9(2018 Sep), pp. 1727-1733. [10.1016/j.jpedsurg.2017.12.020]

Continence after posterior sagittal anorectoplasty for anorectal malformations: comparison of different scores

F. Macchini;A. Di Cesare;E. Leva
2018-09

Abstract

Purpose: To evaluate bowel function in patients with anorectal malformations (ARM) comparing existing scoring systems. Methods: Parents of ARM patients treated at our institution were asked to fill in Holschneider, Kricknebeck, and Rintala questionnaires. Scores obtained from the questionnaires were expressed per cent and analyzed depending on the age and type of ARM according to Krickenbeck classification. Patients younger than 3 years of age or with developmental delay were excluded. Results: Eighty patients (42 males: 52%) were included. Median age was 7.6 years (range 3–22). Twenty eight patients (35%) had perineal fistula, 13 (16%) bulbar, 7 (9%) prostatic, 5 (6%) rectobladder neck, 15 (19%) vestibular, 7 (9%) had a cloaca and 5 (6%) imperforate anus without fistula. Using Holschneider, Krickenbeck, and Rintala, average scores were respectively 72, 71 and 73 (p = 0.4 with ANOVA). Using the three questionnaires patients with perineal fistula scored 82, 76 and 84 respectively (p = 0.003), with bulbar 70, 71, 73 (p = 0.8), with prostatic 52,69,59 (p = 0.06), with bladder neck 56, 80, 57 (p = 0.004), with vestibular 75,67,75 (p = 0.02), with cloaca 64, 67, 65 (p = 0.9), and with imperforate anus without fistula 61,49, 53 (p = 0.12). Patients from 3 to 6 years of age scored 74,72 and 76 (p = 0.37), from 7 to 12: 70,71 and 71 (p = 0.87), and older than twelve: 74,66 e 73 (p = 0.08). Conclusion: The scores obtained using Holschneider, Rintala, and Krickenbeck questionnaires are significantly lower with increasing severity of the ARM. For each type of ARM there are some differences in the results obtained using the three questionnaires. In general, Krickenbeck and Peña questionnaires tend to give lower scores in patients with ARMs that have good prognosis, and higher scores for ARMs with poor prognosis. Age is not significantly related to the score obtained. Level of evidence: III Type of study: Diagnostic study
Anorectal malformation; Bowel function; Constipation; Fecal incontinence; Scores; Soiling; Adolescent; Anal Canal; Anorectal Malformations; Child; Child, Preschool; Cross-Sectional Studies; Fecal Incontinence; Female; Humans; Male; Postoperative Complications; Rectum; Young Adult; Severity of Illness Index
Settore MED/20 - Chirurgia Pediatrica e Infantile
dic-2017
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/752389
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