Search: id:"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 ...
Numbers
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LIBRIS-ID:oai:lup.lub.lu.se:4e08332a-ed0d-4671-9b12-139c549b9f65
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https://lup.lub.lu.se/record/4e08332a-ed0d-4671-9b12-139c549b9f65URI
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https://doi.org/10.1016/j.jpedsurg.2022.02.015DOI
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Language:English
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Summary in:English
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Subject category:art swepub-publicationtype
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Subject category:ref swepub-contenttype
Notes
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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)
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Iacobelli, Barbara D.Bambino Gesù Children’s Hospital
(author)
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Sloots, Cornelius E.J.Sophia Children's Hospital
(author)
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Morandi, AnnaMaggiore Hospital Policlinico
(author)
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Broens, Paul M.A.University Medical Center Groningen
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Makedonsky, IgorChildren's Hospital Dnepropetrovsk
(author)
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Leon, Francesco FascettiUniversity of Padova
(author)
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Schmiedeke, EberhardKlinikum Bremen-Mitte
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Vázquez, Araceli García12 de Octubre University Hospital
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Miserez, MarcCatholic University of Leuven
(author)
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Lisi, GabrieleUniversity G.d'Annunzio of Chieti-Pescara
(author)
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Midrio, PaolaTreviso Hospital
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Amerstorfer, Eva E.Medical University of Graz
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Fanjul, MariaHospital Gregorio Maranon
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Ludwiczek, JohannaKepler University Hospital Linz
(author)
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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)
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van der Steeg, Alida F.W.Academic Medical Center of University of Amsterdam (AMC),Princess Maxima Center for Pediatric Oncology/Hematology
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de Blaauw, IvoRadboud University Medical Center
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Radboud University Medical CenterBambino Gesù Children’s Hospital
(creator_code:org_t)
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On behalf of the ARM-Net Consortium
Related titles
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In:Journal of Pediatric Surgery: Elsevier BV57:9, s. 89-960022-3468
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Morandi, Anna
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Makedonsky, Igor
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Lisi, Gabriele
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Midrio, Paola
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Fanjul, Maria
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