Do Low-Type Anorectal Malformations Have a Better Prognosis than the Intermediate and High Types? A Preliminary Report Using the Krickenbeck Score

Daher, P.; Daher, Renato Tavares; Riachy, Edward; Zeidan, Smart

doi:10.1055/s-2007-965462

Cited by 9 publications

(14 citation statements)

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“…Also, the complications recorded were similar to previous reports 20,21 . These were mainly anal stenosis which was more common among children with intermediate lesions and an observed significant statistical difference ( P < 0.0002) was recorded when they were compared.…”

Section: Discussionsupporting

confidence: 88%

“…Also, the complications recorded were similar to previous reports. 20,21 These were mainly anal stenosis which was more common among children with intermediate lesions and an observed significant statistical difference (P < 0.0002) was recorded when they were compared. Serial dilations were successful in all except one patient that required re-operation following complete occlusion of the anus.…”

Section: Discussionmentioning

confidence: 89%

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Primary perineal surgeries for the low and intermediate anorectal anomalies: 5‐year results in a developing country

Osifo¹,

2009

Surgical Practice

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Aim:The late presentation of clinically unstable children with anorectal anomaly requires the creation of a prior colostomy. The objective of the present study was to examine the feasibility and applicability of primary perineal surgeries for low and intermediate anorectal anomalies without a prior colostomy. Methods: A 5-year experience with consecutive cases of children that had primary perineal surgeries for low/intermediate anorectal anomaly at Results: A total of 29 children aged between 1 day and 3 years (mean 5.4 months Ϯ 2.7), comprising 17 males and 12 females with a male/female ratio of 1.4:1 had primary perineal surgeries for low 19 (65.5%) and intermediate 10 (34.5%) anorectal anomalies. They accounted for 15.6% of children who underwent gastrointestinal operations, and diagnosis was mainly clinical in the majority of them. Transposition anorectoplasty done in 19 (65.5%) children was the commonest procedure, followed by anterior perineal anorectal pullthrough in six (20.7%) and cutback anoplasty in four (13.8%). Anal stenosis which responded to serial dilatation was the main complication and it was statistically significant for the intermediate group compared to the low group (P < 0.0002). More children among the low group had recurrent constipation, although no significant statistical difference was observed when this was compared (P < 0.6451). Overall, 27 (93.1%) children, comprising 18 low and nine intermediate lesions, were successfully managed whereas one (3.4%) child with intermediate lesion had revision surgery with one (3.4%) mortality recorded due to sepsis. Conclusion: Primary perineal surgeries without a prior colostomy in children with low and intermediate anorectal anomaly were feasible, applicable and should be used in our setting.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 89%

Primary perineal surgeries for the low and intermediate anorectal anomalies: 5‐year results in a developing country

Osifo¹,

2009

Surgical Practice

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“…They were, however, associated with poor outcomes due especially to the risk of sepsis, incontinence, recurrent constipation and failure to thrive until in recent decades when breakthrough in the management of the lesion was recorded. [1,2,10] Although policy makers in third world countries place emphasis on enlightening the public on the prevention of communicable diseases and early detection of breast cancer, not much attention has been paid to congenital non-communicable diseases. [1,2] Consequently, many children with congenital anorectal lesions are subjected to extensive perineal cuts, tattoos of their abdomen and ingestion of native concoctions with its associated hazards as seen in index case.…”

Section: Palm Kernels Impaction In Anorectal Malformation: An Unusualmentioning

confidence: 99%

Palm kernels impaction in anorectal malformation: An unusual presentation in an 8-year-old boy

Osifo¹,

Akpanudoh²,

Osagie³

2011

Afr J Paediatr Surg

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“…Eine weitere Aufschlüsselung der funktionellen Ergebnisse innerhalb dieser beiden Gruppen erfolgte in der Vergangenheit meist nicht. Die Krickenbeck-Klassifikation fand seit Ihrer Einführung lediglich in wenigen Studien Anwendung [4,7,15]. Obwohl diese eine detaillierte und standardisierte Darstellung der Ergebnisse nach operativer Korrektur von ARM ermöglicht, bleibt die Diskussion des postoperativen Outcomes uneinheitlich.…”

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“…Hasset et al [15] führten bei allen Ihren Patienten eine PSARP durch und konnten die postoperativen Ergebnisse in Abhängigkeit der Art der ARM diskutieren. Die Studien von Demirogullari et al [7] und Daher et al [4] hingegen fokussierten entweder auf die Korrelation der Ergebnisse mit den anatomischen Gegebenheiten oder den verschiedenen Operationstechniken.…”

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Funktioneller Outcome von Kindern mit Morbus Hirschsprung und Analatresie

Obermayr¹,

Fuchs²

2009

Zentralbl Chir

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Various outcomes following operative therapy for Hirschsprung's disease and anorectal malformations have been reported. Operative techniques for anorectal reconstruction have been modified several times in the past. Repair of anorectal -malformations have been performed through a posterior sagittal approach since the 1980s. This -allows an anatomically correct reconstruction of the anorectal canal. Abdominoperineal or sacro-abdominoperineal pull-through procedures, as the classical operative techniques, have been abandoned by most surgeons. Rectosigmoid-ectomy with colo-anal anastomosis, as described by Swenson and Bill in 1948, as well as the retro-rectal pull-through (Duhamel) and the endorectal pull-through (Soave) are still frequently used in surgery for Hirschsprung's disease. The development of the transanal endorectal pull-through with (Georgeson) or without (de la Torre) laparoscopic assistance has eliminated the necessity of laparotomy in selected cases. Despite significant progress in the understanding of the pathophysiology of and therapy for Hirschsprung's dis-ease and anorectal malformations, the functional results remain unsatisfactory. Functional problems occur already in early childhood and de-crease the quality of life significantly. Although complications resolve with time and the quality of life normalises in adolescence and adulthood, this might be mainly due to an adaptation strategy by the patients. For the future, a standardised and prospective study design is necessary to compare different procedures and to provide a basis for the further development of therapeutic strategies.

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Do Low-Type Anorectal Malformations Have a Better Prognosis than the Intermediate and High Types? A Preliminary Report Using the Krickenbeck Score

Abstract: Basic ideas about anorectal malformations will continue to be modified when the criteria are changed. The use of the Krickenbeck score will help to standardize the results of studies.

Cited by 9 publications

References 10 publications

Primary perineal surgeries for the low and intermediate anorectal anomalies: 5‐year results in a developing country

Primary perineal surgeries for the low and intermediate anorectal anomalies: 5‐year results in a developing country

Palm kernels impaction in anorectal malformation: An unusual presentation in an 8-year-old boy

Funktioneller Outcome von Kindern mit Morbus Hirschsprung und Analatresie

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