Assessment of postoperative results in anorectal malformations

Bhatnagar, Veereshwar

doi:10.4103/0971-9261.16466

Cited by 9 publications

(10 citation statements)

References 23 publications

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“…Size of anal opening, anal tone, and bowel habits were assessed during follow-up visits. The results (postoperative fecal continence) were judged by Kelly's continence score,[ 9 ] 6 months, 1 year, and 4 years postoperatively. The follow-up period ranged from 1 to 4½ years [ Table 1 ].…”

Section: Methodsmentioning

confidence: 99%

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Anorectal malformations: Definitive management during and beyond adolescence

Sham

Singh

Phadke

2012

J Indian Assoc Pediatr Surg

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Aim:To evaluate our results of definitive repair of anorectal malformations in patients with delayed presentation, during and beyond adolescence.Material and Methods:It is a retrospective analysis of all adolescent patients presenting for the first time for definitive repairs and innate patients - colostomy performed during the neonatal period, but who had lost to follow-up. It includes 15 patients (2 male and 13 female) aged from 13 to 32 years. Three well-decompressed female patients were managed by primary anterior sagittal anorectoplasty (ASARP). Twelve patients underwent staged procedures. Five patients (two male and three female) underwent posterior sagittal anorectoplasty (PSARP). The oldest male patient underwent abdominal-PSARP.Results:All of them attained socially acceptable fecal continence at follow-up of 1–4½ years. They are satisfied with the functional and cosmetic outcome of repair of their anomalies.Conclusions:Prospects of fecal continence are good when definitive repair of anorectal malformations is done by an expert, even in the adolescent age group and beyond.

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Section: Methodsmentioning

confidence: 99%

“…Proximal diversion in the form of window colostomy, proximal ileostomy, end colostomy after division of fistula, or end colostomy after coloplasty has been described as the first step. [ 9 11 ] None of the above, best-suited our case. Here, the pouch was grossly dilated and fecally loaded.…”

Section: Methodsmentioning

confidence: 99%

Anorectal malformations: Definitive management during and beyond adolescence

Sham

Singh

Phadke

2012

J Indian Assoc Pediatr Surg

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“…The study also found that anorectal manometry assesses functional compliance, correlates well with Kelly's score and can predict long-term results, and should be used for decision regarding re-operation. 17 We had one child who underwent SPM, and the child had persistent urinary leak from the neorectum following SPM. The child was treated with a redo surgery (PSARP).…”

Section: Discussionmentioning

confidence: 99%

Faecal Continence in Anorectal Malformation, a Correlation with Preoperative and Postoperative Parameters

Abdul¹,

Vasudevan²

2020

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BACKGROUND Anorectal malformations are one of the most common congenital defects encountered in paediatric surgery. Operative procedures aim in attaining bowel control which implies the ability to detect and retain flatus and stool until the appropriate time for evacuation. The study aims to determine the fecal continence in anorectal malformation and its correlation with few preoperative and postoperative parameters. METHODS 60 patients who had completed surgery for anorectal malformation and on follow up in department of Paediatric Surgery, Medical College Kottayam were studied in terms of vertebral anomalies, type of fistula, surgical procedure, position of anus and functional results. Functional results were assessed by Kelly score. RESULTS Kelly's score showed that cases treated with PSARP (26.7%) had fair scores. SPM had good score in 28.6%, fair in 50% and poor in 21.4%. Skeletal anomalies was seen in 16% cases of which 90% had only fair scores. Score was good for anocutaneous fistula and vestibular fistula. All bladder neck fistulas and bulbar fistulas had fair scores (100%) while for prostatic fistula, the scores was good in 6.7%, fair in 73.3% and poor in 20% CONCLUSIONS Kelly's scoring showed inadequate stooling outcome scores in cases with vertebral anomalies, prostatic fistulas. Scores were fair following PSARP, while in SPM the cases were seen in all groups-good, fair and poor. Many of the patients had improvement in their scores when specific intervention was implemented and thus will improve their quality of life.

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“…In the study Urological problems or faecal continence during long-term follow-up of patients with anorectal malformation, Senel E et al reported that urinary system pathology was detected in 35 (37.6%) of the cases with 22 (23.7%) having severe uropathology. 12 As per the study, Assessment of postoperative results in anorectal malformations, V Bhatnagar et al 14 reported that the incidence of postoperative urinary incontinence in ARM patients ranges from 0 to 10% in patients with low ARM, up to 28% in patients with high ARM in the pre-PSARP period and significant reduction in the post-PSARP period (8-10%). Studies have shown that a high percentage of preoperative patients with ARM have occult neurovesical dysfunction (small capacity bladder, uninhibited detrusor contractions, poor compliance, etc.)…”

Section: Armmentioning

confidence: 95%

Urological Abnormalities in Anorectal Malformation- A Single Centre Experience

Beena¹,

Salam²,

Kazia³

2019

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BACKGROUNDAssociation of anorectal malformations (ARM) and urological abnormalities have long since been described in literature. Studies have recommended that all children with ARM should undergo an USG of the urinary tract in the neonatal period. The role of MCU pre-and post-operatively has not been emphasized in literature. Our study was undertaken to study the urological abnormalities associated with ARM and the variations that have occurred postoperatively.METHODS 60 patients who had completed all stages of surgery for anorectal malformation and were on follow up, in the department of Paediatric Surgery, Medical College, Kottayam, were studied for associated anomalies, procedural complications and functional results with regard to urinary system. Post-operative assessment of these patients was done by interviewing the parents, urological assessment by clinical examination scoring and retrospectively studying the medical records available with the patient. Statistical analysis of data was done by chi-square test. RESULTSOf the 60 patients included in the study, majority were below 3 years of age (45%) while 15% were above 6 years of age. Associated anomalies were seen in 50% of cases. Commonest associated anomaly was genitourinary anomaly (31.7%). The surgical procedures done were PSARP in 26.7%, ASARP in 25%, SPM in 23.3%, anoplasty in 20% and abdomino-perineal pull through in 5% patients. Dribbling of urine was seen in 66.7% cases treated with abdomino perineal pull through, 64.3% treated with SPM and in 50% cases of PSARP. None had complete incontinence. Post-operative urological problems in the form of vesico-ureteric reflux /neurogenic bladder was seen in 7 patients (11.7%). Out of the 7, majority had undergone PSARP (6 cases). CONCLUSIONSPostoperative urinary symptoms in the form of dribbling of urine was seen more in SPM patients while urinary tract infections and VUR was seen more following PSARP than in SPM patients. This points to the need for a complete urological evaluation both before and after the definitive procedure.

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Assessment of postoperative results in anorectal malformations

Cited by 9 publications

References 23 publications

Anorectal malformations: Definitive management during and beyond adolescence

Anorectal malformations: Definitive management during and beyond adolescence

Faecal Continence in Anorectal Malformation, a Correlation with Preoperative and Postoperative Parameters

Urological Abnormalities in Anorectal Malformation- A Single Centre Experience

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