Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
van, der, Steeg, HJJ; van, Rooij, IALM; Iacobelli, BD; Sloots, CEJ; Morandi, A; Broens, PMA; Makedonsky, I; Leon, FF; Schmiedeke, E; Vázquez, AG; Miserez, M; Lisi, G; Midrio, P; Amerstorfer, EE; Fanjul, M; Ludwiczek, J; Stenström, P; van, der, Steeg, AFW; de, Blaauw, I, , On-behalf-of-the-ARM-Net-Consortium.
Bowel function and associated risk factors at preschool and early childhood age in children with anorectal malformation type rectovestibular fistula: An ARM-Net consortium study.
J Pediatr Surg. 2022; 57(9):89-96
Doi: 10.1016/j.jpedsurg.2022.02.015
Web of Science
PubMed
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FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Amerstorfer Eva
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- Abstract:
- BACKGROUND: Outcome of patients operated for anorectal malformation (ARM) type rectovestibular fistula (RVF) is generally considered to be good. However, large multi-center studies are scarce, mostly describing pooled outcome of different ARM-types, in adult patients. Therefore, counseling parents concerning the bowel function at early age is challenging. Aim of this study was to evaluate bowel function of RVF-patients at preschool/early childhood age and determine risk factors for poor functional outcome. METHODS: A multi-center cohort study was performed. Patient characteristics, associated anomalies, sacral ratio, surgical procedures, post-reconstructive complications, one-year constipation, and Bowel Function Score (BFS) at 4-7 years of follow-up were registered. Groups with below normal (BFS < 17; subgroups 'poor' ≤ 11, and 'fair' 11 < BFS < 17) and good outcome (BFS ≥ 17) were formed. Univariable analyses were performed to detect risk factors for outcome. RESULTS: The study included 111 RVF-patients. Median BFS was 16 (range 6-20). The 'below normal' group consisted of 61 patients (55.0%). Overall, we reported soiling, fecal accidents, and constipation in 64.9%, 35.1% and 70.3%, respectively. Bowel management was performed in 23.4% of patients. Risk factors for poor outcome were tethered cord and low sacral ratio, while sacral anomalies, low sacral ratio, prior enterostomy, post-reconstructive complications, and one-year constipation were for being on bowel management. CONCLUSIONS: Although median BFS at 4-7 year follow-up is nearly normal, the majority of patients suffers from some degree of soiling and constipation, and almost 25% needs bowel management. Several factors were associated with poor bowel function outcome and bowel management. LEVEL OF EVIDENCE: Level III.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult - administration & dosage
- Anal Canal - abnormalities, surgery
- Anorectal Malformations - complications, epidemiology, surgery
- Child - administration & dosage
- Child, Preschool - administration & dosage
- Cohort Studies - administration & dosage
- Constipation - complications
- Follow-Up Studies - administration & dosage
- Humans - administration & dosage
- Rectal Fistula - epidemiology, etiology, surgery
- Rectum - surgery
- Retrospective Studies - administration & dosage
- Risk Factors - administration & dosage
- Treatment Outcome - administration & dosage
- Find related publications in this database (Keywords)
- Anorectal malformation
- Rectovestibular fistula
- Bowel function score
- Preschool age
- Early childhood
- ARM-Net
- Type of study
- Observational cohort-study