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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
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- van der Steeg, Hendrik J.J. (author)
- Radboud University Medical Center
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- van Rooij, Iris A.L.M. (author)
- Radboud University Medical Center
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- Iacobelli, Barbara D. (author)
- Bambino Gesù Children’s Hospital
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- Sloots, Cornelius E.J. (author)
- Sophia Children's Hospital
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- Morandi, Anna (author)
- Maggiore Hospital Policlinico
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- Broens, Paul M.A. (author)
- University Medical Center Groningen
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- Makedonsky, Igor (author)
- Children's Hospital Dnepropetrovsk
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- Leon, Francesco Fascetti (author)
- University of Padova
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- Schmiedeke, Eberhard (author)
- Klinikum Bremen-Mitte
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- Vázquez, Araceli García (author)
- 12 de Octubre University Hospital
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- Miserez, Marc (author)
- Catholic University of Leuven
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- Lisi, Gabriele (author)
- University G.d'Annunzio of Chieti-Pescara
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- Midrio, Paola (author)
- Treviso Hospital
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- Amerstorfer, Eva E. (author)
- Medical University of Graz
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- Fanjul, Maria (author)
- Hospital Gregorio Maranon
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- Ludwiczek, Johanna (author)
- Kepler University Hospital Linz
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- Stenström, Pernilla (author)
- Lund 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
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- van der Steeg, Alida F.W. (author)
- Princess Maxima Center for Pediatric Oncology/Hematology,Academic Medical Center of University of Amsterdam (AMC)
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- de Blaauw, Ivo (author)
- Radboud University Medical Center
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(creator_code:org_t)
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- Elsevier BV, 2022
- 2022
- English.
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In: Journal of Pediatric Surgery. - : Elsevier BV. - 0022-3468. ; 57:9, s. 89-96
- Related links:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
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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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Keyword
- Anorectal malformation
- ARM-Net
- Bowel function score
- Early childhood
- Observational cohort-study
- Preschool age
- Rectovestibular fistula
- Type of study
Publication and Content Type
- art (subject category)
- ref (subject category)
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van der Steeg, H ...
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van Rooij, Iris ...
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Iacobelli, Barba ...
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Sloots, Corneliu ...
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Morandi, Anna
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Broens, Paul M.A ...
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Makedonsky, Igor
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Leon, Francesco ...
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Schmiedeke, Eber ...
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Vázquez, Araceli ...
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Miserez, Marc
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Lisi, Gabriele
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Midrio, Paola
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Amerstorfer, Eva ...
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Fanjul, Maria
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Ludwiczek, Johan ...
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Stenström, Perni ...
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van der Steeg, A ...
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de Blaauw, Ivo
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MEDICAL AND HEAL ...
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Lund University