Open Access Open Access  Restricted Access Subscription Access

ASSESSMENT OF CONTINENCE AND QUALITY OF LIFE FOLLOWING POSTERIOR SAGITTAL REPAIR IN CHILDREN WITH ANORECTAL MALFORMATION

Rizwan Ahmad Khan, Rajendra Singh Chana

Abstract


Aim: To evaluate the outcome of posterior sagittal repair in children with anorectal malformations by assessing the continence and quality of life in these children.

Methods: The patients of anorectal malformation who underwent definitive repair with posterior sagittal approach were studied for continence and quality of life. We evaluated the continence by giving a score to the grade of continence as per the Krickenbeck criteria (higher the score better the continence). Quality of life was assessed as per the structured questionnaire based on a specific questionnaire and was compared with the age matched controls. 

Results: Thirty-eight patients operated on for anorectal malformations were evaluated. The male to female ratio was 1.1. Genitourinary abnormalities were the most common associated abnormalities present in 18.4% of the cases. Among al the age groups and subtypes of Anorectal malformation, male children of peroneal fistula had the best continence and QoL score. With increasing age, the quality of life score worsens in female ARM patients.

Conclusions: Continence and quality of life is better in low anorectal malformation and improves with age. At adolescent age, female patients of anorectal malformation show poor quality of life. The results of postoperative assessment of children with anorectal malformation by using Krickenbeck’s method (with incorporated scoring) and quality of life are reasonable and easily comparable.

Keywords


Anorectal malformation, Posterior sagittal anorectoplasty, Continence, Quality of life, Anorectoplasty, Sagittal repair.

Full Text:

PDF

References


Bai Y, Yuan Z, Wang W, Zhao Y, Wang H, and Wang W. (2000). “Quality of life for children with fecal incontinence after surgically corrected anorectal malformation”, J Pediatr Surg, Vol.35(3), pp.462-464.

Bhat NA, Grover VP, and Bhatnagar V. (2004). “Manometric evaluation of postoperative patients with anorectal anomalies”, Indian J Gastroenterol, Vol.23, pp.206-208.

Davies MC, Creighton SM, and Wilcox DT. (2004). “Long-term outcomes of anorectal malformations”, Pediatr Surg Int, Vol.20(8), pp.567-572.

Fukata R, Iwai N, Yanagihara J, Iwata G, and Kubota Y. (1997). “A comparison of anal endosonography with electromyography and manometry in high and intermediate anorectal anomalies”, J Pediatr Surg, Vol.32, pp.839-842.

Fukuya T, Honda H, Kubota M, Hayashi T, Kawashima A, and Tateshi Y, et al. (1993). “Postoperative MRI evaluation of anorectal malformations with clinical correlation”, Pediatr Radiol, Vol.23, pp.583-586.

Grosfeld JL. (2006). “ARM-a Historical Overview”, In Holschneider AM, and Hutson JM. (eds). “Anorectal malformation in children, embryology, diagnosis, surgical treatment, follow up”, Springer, Berlin, pp.3-11.

Grano C, Aminoff D, Lucidi F, and Violani C. (2012). “Long-term disease-specific quality of life in children and adolescent patients with ARM”, J Pediatr Surg, Vol.47, pp.1317–1322.

Hanneman MJG, Sprangers MAG, and De Mik EL et al. (2001). “Quality of life in patients with anorectal malformation or Hirschprung’s disease”, Dis Colon rectum, Vol.44, pp.1650-1660.

Holschneider A, Hutson J, and Pena A, et al. (2005). “Preliminary report on the International Conference for the Development of Standards for the Treatment of Anorectal Mal¬formations”, Journal of pediatric surgery, Vol.40(10), pp.1521-1526.

Holschneider A, Hutson J, and Pena A et al. (2005). “Preliminary report on the International Conference for the Development of Standards for the Treatment of Anorectal Malformations”, J Pediatr Surg, Vol.40, pp.1521-1526.

Kaselas C, Philippopoulos A, and Petropoulos A. (2011). “Evaluation of long-term functional outcomes after surgical treatment of anorectal malformations”, Int J Colorectal Dis, Vol.26, pp.351-356.

Keramidas DC, Soutis M, Mavridis G, and Papandreou E. (2005). “Rectosigmoid ectasia associated with anorectal anomaly repair: experience with sigmoid anterior resection and endorectal pull-through”, Eur J Pediatr Surg, August, Vol.15(4), pp.268-272.

Nah SA, Ong CC, Lakshmi NK, Yap TL, Jacobsen AS, and Low Y. (2012). “Anomalies associ¬ated with anorectal malformations according to the Krickenbeck anatomic classifica¬tion”, Journal of pediatric surgery, Vol.47, pp.2273-2278.

Nievelstein RA, Vos A, and Valk J. (1998). “MR imaging of anorectal malformations and associated anomalies”, Eur Radiol, Vol.8(4), pp.573-581.

Pena A. (1988). “Surgical management of anorectal malformations: a unified concept”, Pediatr Surg Int, Vol.3, pp.82-93.

Pena A, and Devries PA. (1982). “Posterior sagittal anorectoplasty: important technical considerations and new applications”, Journal of pediatric surgery, Vol.17, pp.796-811.

Pena A, and Hong A. (2000). “Advances in the management of anorectal malformations”, Am J Surg, Vol.180, pp.370-376.

Rintala R, Mildh L, and Lindahl H. (1992). “Fecal continence and quality of life in adult patients with an operated low anorectal malformation”, J Pediatr Surg, Vol.27(7), pp.902-905.

Rintala R, Mildh L, and Lindahl H. (1994). “Fecal continence and quality of life in adult patients with an operated high or inter- mediate anorectal malformation”, J Pediatr Surg, Vol.29(6), pp.770-780.

Rintala RJ, and Lindhal H. (1995). “Is normal bowel function possible after repair of intermediate and high anorectal malformations?”, Journal of Pediatric Surgery, Vol.30, pp.491-494.

Sachs TM, Applebaum H, Touran T, Taber P, Darakjian A, and Colleti P. (1990). “Use of MRI in evaluation of anorectal anomalies”, J Pediatr Surg, Vol.25, pp.817-821.

Shandling B, Gilmour R, and Ein S. (1991). “The anal sphincter force in the evaluation of postoperative imperforate anus”, J Pediatr Surg, Vol.26(12), pp.1369-1371.

Shireen AN, Caroline CPO, Narasimhan KL, Yap TL, Jacobsen AS, and Low Y. (2012). “Anomalies associated with anorectal malformations according to the Krickenbeck anatomic classification”, Journal of Pediatric Surgery, Vol.47, pp.2273-2278.

Stephens FD, and Smith ED. (1986). “Classification, identification and assessment of surgical treatment of anorectal anomalies”, Report of a work meeting held on May25-271984 at wingspread convention center, The Johnson foundation, Racine, Wisconsin, USA, Pediatric Sug Int, Vol.1(4), pp.200-205.

Yong C, Ruo-yi W, Yuan Z, Shu-hui Z, and Guang-Rui S. (2013). “MRI findings in patients with defecatory dysfunction after surgical correction of anorectal malformation”, Pediatr Radiol, Vol.43(8), pp.964-970.


Refbacks

  • There are currently no refbacks.


Send mail to ijsss@ijsss.com with questions or comments about this web site. 

International Journal of Surgery and Surgical Sciences, All rights reserved.