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Preliminary report on the International Conference for the Development of Standards for the Treatment of Anorectal Malformations |
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| Authors: | Holschneider Alexander Hutson John Peña Albert Beket Elhamy Chatterjee Subir Coran Arnold Davies Michael Georgeson Keith Grosfeld Jay Gupta Devendra Iwai Naomi Kluth Dieter Martucciello Giuseppe Moore Samuel Rintala Risto Smith E Durham Sripathi D V Stephens Douglas Sen Sudipta Ure Benno Grasshoff Sabine Boemers Thomas Murphy Feilin Söylet Yunus Dübbers Martin Kunst Marc |
| Institution: | a Department of Surgery, Kinderkrankenhaus of the City of Cologne, Amsterdamerstr. 59, 50735 Cologne, Germany b Department of General Surgery Royal Children's Hospital, Melbourne, Parkville, 3052, Australia c Division of Pediatric Surgery, The Colorectal Center for Children, Cincinnati Children's Hospital, ML 2023, Cincinnati, OH 45229, USA d Medical Imaging Department, Royal Children's Hospital, Melbourne, Parkville 3052, Australia e Park Clinic, Kolkata 700.017, India f Mott Children's Hospital, Ann Arbor, MI 48109 g Red Cross Memorial Hospital, Cape Town, South Africa h Children's Hospital of Alabama, Birmingham, AL 35233 i Riley Children's Hospital, Indianapolis, IN 46202 j All India Institute of Medical Sciences, New Delhi, 110029, India k Kyoto Prefectural University, Kyoto 602-8566, Japan l Universitätsklinikum Eppendorf, Hamburg 20246, Germany m Department of Pediatric Surgery, University Pavia, Pavia, Italy n University of Stellenbusch, Tygerberg, 7505, South Africa o Children's Hospital, University of Helsinki, Helsinki, Finland p Unit 3, 42 Severn Street, North Balwyn, Victoria 3052, Australia q 1 Damodara Mudali Street, Chepet Chennai, 600031 India r Royal Children's Hospital Melbourne, Parkville, 3052 Australia s Christian Medical College Hospital, Tamil Nadu 632004, India t Medizinische Hochschule Hannover, Hannover 30635, Germany u Medical University Klinik, Würzberg, Germany v University of Salzburg, Salzburg, Austria w Our Lady's Children's, Hospital, Crumlin, Dublin, Ireland x Children's Hospital Istanbul University, Istanbul, Turkey y Kinderkrankenhaus City of Cologne, Cologne, 50735 Germany |
| Abstract: | BackgroundAnorectal malformations (ARM) are common congenital anomalies seen throughout the world. Comparison of outcome data has been hindered because of confusion related to classification and asssessment systems.MethodsThe goals of the Krinkenbeck Conference on ARM was to develop standards for an International Classification of ARM based on a modification of fistula type and adding rare and regional variants, and design a system for comparable follow up studies.ResultsLesions were classified into major clinical groups based on the fistula location (perineal, recto-urethral, recto-vesical, vestibular), cloacal lesions, those with no fistula and anal stenosis. Rare and regional variants included pouch colon, rectal atresia or stenosis, rectovaginal fistula, H-fistula and others. Groups would be analyzed according to the type of procedure performed stratified for confounding associated conditions such as sacral anomalies and tethered cord. A standard method for postoperative assessment of continence was determined.ConclusionsA new International diagnostic classification system, operative groupings and a method of postoperative assessment of continence was developed by consensus of a large contingent of participants experienced in the management of patients with ARM. These methods should allow for a common standardization of diagnosis and comparing postoperative results. |
| Keywords: | Classification of anorectal malformation Wingspread classification Krickenbeck classification |
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