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  • van der Steeg, H. J.J.Radboud University Medical Center (author)

The impact of perioperative care on complications and short term outcome in ARM type rectovestibular fistula : An ARM-Net consortium study

  • Article/chapterEnglish2019

Publisher, publication year, extent ...

  • Elsevier BV,2019

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  • LIBRIS-ID:oai:lup.lub.lu.se:3c053936-5e0a-432f-b766-a4a44cc15bc0
  • https://lup.lub.lu.se/record/3c053936-5e0a-432f-b766-a4a44cc15bc0URI
  • https://doi.org/10.1016/j.jpedsurg.2019.03.008DOI

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  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • Background: The impact of perioperative care interventions on postreconstructive complications and short-term colorectal outcome in patients with anorectal malformation (ARM) type rectovestibular fistula is unknown. Methods: An ARM-Net consortium multicenter retrospective cohort study was performed including 165 patients with a rectovestibular fistula. Patient characteristics, perioperative care interventions, timing of reconstruction, postreconstructive complications and the colorectal outcome at one year of follow-up were registered. Results: Overall complications were seen in 26.8% of the patients, of which 41% were regarded major. Differences in presence of enterostomy, timing of reconstruction, mechanical bowel preparation, antibiotic prophylaxis and postoperative feeding regimen had no impact on the occurrence of overall complications. However, mechanical bowel preparation, antibiotic prophylaxis ≥ 48 h and postoperative nil by mouth showed a significant reduction in major complications. The lowest rate of major complications was found in the group having these three interventions combined (5.9%). Multivariate analyses did not show independent significant results of any of the perioperative care interventions owing to center-specific combinations. At one year follow-up, half of the patients experienced constipation and this was significantly higher among those with preoperative mechanical bowel preparation. Conclusions: Differences in perioperative care interventions do not seem to impact the incidence of overall complications in a large cohort of European rectovestibular fistula-patients. Mechanical bowel preparation, antibiotic prophylaxis ≥ 48 h, and postoperative nil by mouth showed the least major complications. Independency could not be established owing to center-specific combinations of interventions. Type of study: Treatment study. Level of evidence: III

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  • van Rooij, I. A.L.M.Radboud University Medical Center (author)
  • Iacobelli, B. D.Bambino Gesù Children’s Hospital (author)
  • Sloots, C. E.J.Erasmus University Medical Center (author)
  • Leva, E.Maggiore Hospital Policlinico (author)
  • Broens, P.University Medical Center Groningen (author)
  • Fascetti Leon, F.University of Padova (author)
  • Makedonsky, I.Dnipropetrovsk Oblast Children's Hospital (author)
  • Schmiedeke, E.Klinikum Bremen-Mitte (author)
  • García Vázquez, A.12 de Octubre University Hospital (author)
  • Midrio, P.Treviso Hospital (author)
  • Lisi, G.Civic Hospital Of Pescara,University G.d'Annunzio of Chieti-Pescara (author)
  • Amerstorfer, E.Medical University of Graz (author)
  • Miserez, M.University Hospitals Leuven (author)
  • Fanjul, M.Hospital Gregorio Maranon (author)
  • Ludwiczek, J.Kepler University Hospital Linz (author)
  • Stenström, P.Lund University,Lunds universitet,Barnkirurgi,Forskargrupper vid Lunds universitet,Pediatric surgery,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-pes (author)
  • Giuliani, S.St George's Hospital, London (author)
  • van der Steeg, A. F.W.Emma Children’s Hospital,Amsterdam UMC - Vrije Universiteit Amsterdam (author)
  • de Blaauw, I.Radboud University Medical Center (author)
  • Radboud University Medical CenterBambino Gesù Children’s Hospital (creator_code:org_t)
  • ARM-Net consortium

Related titles

  • In:Journal of Pediatric Surgery: Elsevier BV54:8, s. 1595-16000022-3468

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