首页 | 本学科首页   官方微博 | 高级检索  
     


Continence after posterior sagittal anorectoplasty for anorectal malformations: comparison of different scores
Authors:Giulia Brisighelli  Francesco Macchini  Dario Consonni  Antonio Di Cesare  Anna Morandi  Ernesto Leva
Affiliation:1. Department of Pediatric Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122 Milano, Italy;2. Epidemiology Unit, Fondazione IRCCS Ca'' Granda Ospedale Maggiore Policlinico, Via San Barnaba 8, 20122 Milan, Italy
Abstract:

Purpose

To evaluate bowel function in patients with anorectal malformations (ARM) comparing existing scoring systems.

Methods

Parents of ARM patients treated at our institution were asked to fill in Holschneider, Kricknebeck, and Rintala questionnaires. Scores obtained from the questionnaires were expressed per cent and analyzed depending on the age and type of ARM according to Krickenbeck classification. Patients younger than 3 years of age or with developmental delay were excluded.

Results

Eighty patients (42 males: 52%) were included. Median age was 7.6 years (range 3–22). Twenty eight patients (35%) had perineal fistula, 13 (16%) bulbar, 7 (9%) prostatic, 5 (6%) rectobladder neck, 15 (19%) vestibular, 7 (9%) had a cloaca and 5 (6%) imperforate anus without fistula. Using Holschneider, Krickenbeck, and Rintala, average scores were respectively 72, 71 and 73 (p = 0.4 with ANOVA). Using the three questionnaires patients with perineal fistula scored 82, 76 and 84 respectively (p = 0.003), with bulbar 70, 71, 73 (p = 0.8), with prostatic 52,69,59 (p = 0.06), with bladder neck 56, 80, 57 (p = 0.004), with vestibular 75,67,75 (p = 0.02), with cloaca 64, 67, 65 (p = 0.9), and with imperforate anus without fistula 61,49, 53 (p = 0.12). Patients from 3 to 6 years of age scored 74,72 and 76 (p = 0.37), from 7 to 12: 70,71 and 71 (p = 0.87), and older than twelve: 74,66 e 73 (p = 0.08).

Conclusion

The scores obtained using Holschneider, Rintala, and Krickenbeck questionnaires are significantly lower with increasing severity of the ARM. For each type of ARM there are some differences in the results obtained using the three questionnaires. In general, Krickenbeck and Peña questionnaires tend to give lower scores in patients with ARMs that have good prognosis, and higher scores for ARMs with poor prognosis. Age is not significantly related to the score obtained.

Level of evidence

III

Type of study

Diagnostic study
Keywords:Anorectal malformation  Fecal incontinence  Soiling  Constipation  Bowel function  Scores
本文献已被 ScienceDirect 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号