Prospective follow up of children with anorectal malformation: our center experience until 10 years of age.

Leili Mohajerzadeh, Mohsen Rouzrokh, Ahmad Khaleghnejad Tabari, Alireza Mirshemirani, Naser Sadeghian, Javad Ghoroubi, Fatollah Roshanzamir, Alireza Mahdavi, Maryam Kazemi, Sayeh Hatefi, Arameh Abbasian

Abstract


431

Introduction: the aim of our study was to perform a longitudinal follow-up in patients with anorectal malformations(ARMs) in order to determine the anorectal function problems and help to solve them.

Material and Methods: This study included 262 patients with ARM who were operated between 2006 until 2013.Children whose definitive reconstruction was performed at another hospital and underwent reoperation in our center were excluded. Patients who expired or did not come for follow-up were not included in the study either. Bowel function was prospectively assessed by using a questionnaire answered by the children’s parents. supplementary bowel management with enemas, laxatives and the use of diapers were documented as well.

Results: Interviews were completed in 242 children, ages ranging from 3 to 10 years. More than thirty seven (37.7%) patients had constipation.32.5% Grade 1 (controllable by altering in diet), 54.3% Grade 2 (requiring laxatives) and 13.2% Grade 3(opposed to stool softeners and diet).

18.6% of patients had fecal soiling, 31.5% Grade 1: infrequently (once or twice for every week), 24% Grade 2: daily (no community difficulty) and 44.5% Grade 3: Constant (social problem).

Conclusion: In the present study several bowel function problemswere found in ARM children. physicians who perform the definitive operation on anorectal malformations should  notloose follow up of patients as they grow upbecause they may present with  great troubles during their adolescence.


Keywords


Anorectal malformation; Postoperative complications; Bowel functional outcome; Fecal incontinence

Full Text:

PDF

161

References


Levitt MA, Pen˜a A: Outcomes from the correction of anorectal malformations. Curr Opin Pediatr 2005;17:394–401.

Hondel DV, Sloots CEJ, Gischler SJ, et al: Prospective long-term follow up of children with anorectal malformation. Growth and development until 5 years of age. Journal of Pediatric Surgery 2013;48:818–825.

The WHOQOL group: Development of the WHOQOL: rationale and current status. Int J Ment Health 1994;23:24-56.

Borg HC, Holmdahl G, Gustavsson K, et al: Longitudinal study of bowel function in children with anorectal malformations. Journal of Pediatric Surgery 2013;48:597–606.

Witvliet MJ, Slaar A, Heij HA, et al: Qualitative analysis of studies concerning quality of life in children and adults with anorectal malformations. Journal of Pediatric Surgery 2013;48: 372–379.

Schmidt D, Jenetzky E, Zwink N, et al: Postoperative complications in adults with anorectal malformation: a need for transition. German Network for Congenital Uro-REctal Malformations (CURE-Net). Pediatr Surg Int 2012;28:793–795.

Belizon A, Levitt MA, Shoshany G, et al: Rectal prolapse following posterior sagittal anorectoplasty for anorectal malformations. J Pediatr Surg 2005;40:192- 6.

Borg H, Holmdahl G, Olsson I, et al: Impact of spinal cord malformation on bladder function in children with anorectal malformations. J Pediatr Surg 2009;44:1778-85.

Wilmshurst JM, Kelly R, Borzyskowski M: Presentation and outcome of sacral agenesis: 20 years' experience. Dev Med Child Neurol 1999;41:806-12.

Rintala RJ, Pakarinen MP: Imperforate anus: long- and short-term outcome. Semin Pediatr Surg 2008;17:79-89.

Pen˜a A, Grasshoff S, Levitt M: Reoperations in anorectal malformations. Journal of Pediatric Surgery 2007;42:318– 325

Archibong AE: Results of treatment in children with anorectal malformations in Calabar, Nigeria. SAJS 2004;42:88-90.

Chao HC, Chen SY, Chen CC, et al: The impact of constipation on growth in children. Pediatr Res 2008;64:308-11.

Schmiedeke E, Zwink N, Schwarzer N, et al: Unexpected results of a nationwide, treatment-independent assessment of fecal incontinence in patients with anorectal anomalies. Pediatr Surg Int 2012;28:825–830.

Iwai N, Deguchi E, Kimura O, et al: Social quality of life for adult patients with anorectal malformations. Journal of Pediatric Surgery 2007;42:313–317.

Konuma K, Ikawa H, Kohno M, et al: Sexual problems in male patients older than 20 years with anorectal malformations. J Pediatr Surg 2006;41:306-9.

Granoa C, Aminoff D, Lucidic F, et al: Long-term disease-specific quality of life in adult anorectal malformation patients. J Pediatr Surg 2011;46:691–698.

Hullmann SE, Chalmers LJ, Wisniewski AB: Transition from pediatric to adult care for adolescents and young adults with a disorder of sex development. J Pediatr Adolesc Gynecol 2012;25:155–157.

Holschneider A, Hutson J, Pen˜a A et al: Preliminary report on the international conference for the development of standards for the treatment of anorectal malformations. J Pediatr Surg 2005;40:1521–1526.

Khaleghnejad-Tabari A, Saeeda M: The results of posterior sagittal anorectoplasty in anorectal malformations. Arch Iranian Med 2005;8:272- 276.

Mirshemirani A, Ghorobi J, Roozroukh M, et al: Urogenital Tract Abnormalities Associated with Congenital Anorectal Malformations. Iran J Pediatr 2008;18: 171-174.




DOI: https://doi.org/10.22037/irjps.v2i2.12154

Refbacks

  • There are currently no refbacks.


pISSN: 2423-5067

eISSN: 2423-7612

Creative Commons License
This journal and its contents are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.