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Search: onr:"swepub:oai:lup.lub.lu.se:4e08332a-ed0d-4671-9b12-139c549b9f65" > Bowel function and ...

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

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

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • Elsevier BV,2022

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  • LIBRIS-ID:oai:lup.lub.lu.se:4e08332a-ed0d-4671-9b12-139c549b9f65
  • https://lup.lub.lu.se/record/4e08332a-ed0d-4671-9b12-139c549b9f65URI
  • https://doi.org/10.1016/j.jpedsurg.2022.02.015DOI

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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: 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.

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  • van Rooij, Iris A.L.M.Radboud University Medical Center (author)
  • Iacobelli, Barbara D.Bambino Gesù Children’s Hospital (author)
  • Sloots, Cornelius E.J.Sophia Children's Hospital (author)
  • Morandi, AnnaMaggiore Hospital Policlinico (author)
  • Broens, Paul M.A.University Medical Center Groningen (author)
  • Makedonsky, IgorChildren's Hospital Dnepropetrovsk (author)
  • Leon, Francesco FascettiUniversity of Padova (author)
  • Schmiedeke, EberhardKlinikum Bremen-Mitte (author)
  • Vázquez, Araceli García12 de Octubre University Hospital (author)
  • Miserez, MarcCatholic University of Leuven (author)
  • Lisi, GabrieleUniversity G.d'Annunzio of Chieti-Pescara (author)
  • Midrio, PaolaTreviso Hospital (author)
  • Amerstorfer, Eva E.Medical University of Graz (author)
  • Fanjul, MariaHospital Gregorio Maranon (author)
  • Ludwiczek, JohannaKepler University Hospital Linz (author)
  • Stenström, PernillaLund University,Lunds universitet,Pediatrik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Barnkirurgi,Forskargrupper vid Lunds universitet,Paediatrics (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Pediatric surgery,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-pes (author)
  • van der Steeg, Alida F.W.Academic Medical Center of University of Amsterdam (AMC),Princess Maxima Center for Pediatric Oncology/Hematology (author)
  • de Blaauw, IvoRadboud University Medical Center (author)
  • Radboud University Medical CenterBambino Gesù Children’s Hospital (creator_code:org_t)
  • On behalf of the ARM-Net Consortium

Related titles

  • In:Journal of Pediatric Surgery: Elsevier BV57:9, s. 89-960022-3468

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