Anorectal Malformations

Wood, Richard J.; Levitt, Marc A.

doi:10.1055/s-0037-1609020

Cited by 95 publications

(79 citation statements)

References 38 publications

(39 reference statements)

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“…Normal asymmetrical pattern of pressures in the anal canal is properly a common cause 16 . In patients with ARM hypo-development of the anal sphincter complex in different degrees is common and may alter the pressure distribution as detected by HRAM 17 .…”

Section: Discussionmentioning

confidence: 99%

Correlation of anorectal manometry measures to severity of fecal incontinence in patients with anorectal malformations – a cross-sectional study

Bjørsum-Meyer

Christensen

Jakobsen

et al. 2020

Sci Rep

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Anorectal malformations (ARM) are a spectrum of anomalies of the rectum and anal canal affecting 1 in 2500 to 5000 live births. Functional problems are common and related to the type of ARM and associated malformations. We aimed to evaluate the results of Three-dimensional High Resolution Anorectal Manometry (3D-HRAM) in long-term follow-up after surgical correction of ARM with special reference to fecal incontinence. twenty-one patients with anorectal malformations and primary repair at our center consented to participate in the study. pressures of the anal sphincter muscles and defects were addressed by 3D-HRAM. Fecal incontinence and disease-specific quality of life were evaluated by the fecal incontinence Quality of Life score and Wexner incontinence score respectively. the study was approved by the Committee in Health Research Ethics and the Danish Data Protection Agency. Median age was 22(12-31) years and 13(67%) participants were females. Sphincter defect was present in 48% (n = 10) of participants. Participants with sphincter defects had significant higher Wexner score and size of sphincter defects and mean anal squeeze pressure were correlated to Wexner score. Participants with or without sphincter defects did not differ on manometry parameters including resting anal and squeeze pressure or disease-specific quality of life. In a study of the long-term outcome after repair of anorectal malformations we found a higher Wexner incontinence score in the presence of an anal sphincter defect and the size of the defect and mean anal squeeze pressure were correlated to the Wexner incontinence score.

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Section: Discussionmentioning

confidence: 99%

Correlation of anorectal manometry measures to severity of fecal incontinence in patients with anorectal malformations – a cross-sectional study

Bjørsum-Meyer

Christensen

Jakobsen

et al. 2020

Sci Rep

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“…ARM is a common congenital condition that occurs in one out of 5,000 births and is slightly more prevalent in males. 1 The anatomic variants for ARM depend on the gender of the patient and the distal rectal anatomy. For males, the possibilities include rectal fistulae along the path of the urethra (bladder neck, prostatic, and bulbar), a no fistula defect, or a rectoperineal fistula.…”

Section: Discussionmentioning

confidence: 99%

“…For males, the possibilities include rectal fistulae along the path of the urethra (bladder neck, prostatic, and bulbar), a no fistula defect, or a rectoperineal fistula. 1 During the newborn period, the likelihood of a rectourethral fistula and the predicted distance of the distal rectum from the perineal skin are both taken into consideration when contemplating creation of a diversion. In the case presented, there was no evidence of a perineal fistula in day 1 or two of life, and the air column in the rectum on a lateral prone X-ray was high above the coccyx and perineal skin, prompting the decision to create a colostomy (►Fig.…”

Section: Discussionmentioning

confidence: 99%

“…You review the distal colostogram (►Fig. 1) to assist you in identifying the nature of the malformation as well as to decide on the ideal surgical approach for the repair.…”

Section: Case Reportmentioning

confidence: 99%

“…2 The newborn is observed during the first 24 hours of life for evidence of fistula, which is usually demonstrated by meconium excretion through the skin of the perineum or in the urine. 1 The former is indicative of a rectoperineal fistula, which can often proceed to a newborn repair via PSARP without the need for diversion. Any evidence of a rectourethral fistula warrants diversion with colostomy and delayed repair.…”

Section: New Insights and The Importance For The Pediatric Surgeonmentioning

confidence: 99%

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Image of the Month: How to Select the Ideal Surgical Approach in Male Anorectal Malformation with No Visible Fistula

Apte

McKenna

Levitt

2020

European J Pediatr Surg Rep

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We present a case of a 6-month-old male infant with an anorectal malformation (ARM) who underwent colostomy as a newborn, and now presents for definitive repair. A colostogram is shown to identify the malformation and to help plan for the ideal surgical approach. The case is presented with a focus on surgical strategies for management of ARM in the male infant, with questions for the readers posed in a quiz format.

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Prediction of anorectal malformations with bladder‐neck/urethral‐prostatic fistula using classification and regression tree analysis

Yuan

Feng

Huang

et al. 2022

J of Clinical Ultrasound

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Background The anorectal malformations (ARMs) with bladder‐neck/urethral‐prostatic fistula in males are the most complex groups in ARMs. It is essential to diagnose them effectively before the primary operation for both surgical modalities and future functional prognosis can be quite different from other types. Our study aimed to develop a classification and regression tree (CART) model for the prediction of ARMs with bladder‐neck/urethral‐prostatic fistula. Methods A total of 132 newborns with ARMs were included retrospectively and randomly assigned to the training sample and test sample in a 3:1 ratio. The pouch‐perineum distance of ultrasound (PPDU), the pouch‐perineum distance of invertogram (PPDI), and the rectum gas above the coccyx (RGAC) on the invertogram were hypothesized can serve as individual predictors. The CART analysis was used to determine the best combination of candidate predictors. The model's performance was assessed by the area under the receiver operating characteristic curve (AUC) and validated in the test sample. Results All three individual predictors were included in the CART model to predict the ARMs with bladder‐neck/urethral‐prostatic fistula in the derivation cohort with the following test characteristics (95% CI): sensitivity 75.6% (60.1 to 86.6); specificity 88.9% (76.7 to 95.4); AUC 0.909 (0.854 to 0.965). The model's predicted accuracy was validated in the test cohort (AUC = 0.883). In all 132 subjects, the AUC of the tree model was significantly superior to that of the best individual index: PPDU (0.901 vs. 0.819; p = 0.005). Conclusions A predictive model that consists of PPDU, PPDI, and RGAC may be useful in predicting ARMs with bladder‐neck/urethral‐prostatic fistula.

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Anorectal Malformations

Cited by 95 publications

References 38 publications

Correlation of anorectal manometry measures to severity of fecal incontinence in patients with anorectal malformations – a cross-sectional study

Correlation of anorectal manometry measures to severity of fecal incontinence in patients with anorectal malformations – a cross-sectional study

Image of the Month: How to Select the Ideal Surgical Approach in Male Anorectal Malformation with No Visible Fistula

Prediction of anorectal malformations with bladder‐neck/urethral‐prostatic fistula using classification and regression tree analysis

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