Long‐Term Functional Outcomes of an Anorectal Malformation French National Cohort

Schmitt, Françoise; Scalabre, Aurélien; Mure, Pierre Yves; Borrione, Claude; Lemelle, J.L.; Sharma, Dyuti; Napoli, Stéphan De; Irtan, Sabine; Levard, G.; Baudin, François; Buisson, Philippe; Fourcade, Laurent; Arnaud, Alexis; Vries, P. De; Branchereau, Sophie; Garignon, Cynthia; Sauvat, Frédérique; Kalfa, Nicolas; Hubert, Lardy; Jochault-Ritz, S.; Sapin, Emmanuel; Coridon, H.; Margaryan, M.; Pouzac, Myriam; Carfagna, L.; Poli-Mérol, M.L.; Varlet, François; Sarnacki, Sabine; Crétolle, Célia; Podevin, Guillaume

doi:10.1097/mpg.0000000000003447

Cited by 6 publications

(2 citation statements)

References 22 publications

(31 reference statements)

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“…Fecal incontinence (FI) remains the most frequent and disabling problem after surgery for congenital anorectal malformations (CARMs) (1). FI poses a severe burden on individuals and their families because of physical, psychological, behavioral, and other problems, which cause children to experience guilt and embarrassment (2).…”

Section: Introductionmentioning

confidence: 99%

A Predictive Model to Identify the Effects of Transcutaneous Sacral Nerve Stimulation With Pelvic Floor Exercises in Fecal Incontinence After Surgery for Anorectal Malformation

Shen,

Zhang,

Tao

et al. 2023

Am J Gastroenterol

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Objective: While the combination of transcutaneous sacral nerve stimulation (tSNS) and pelvic floor exercises (PFEs) has shown significant effectiveness in treating faecal incontinence (FI) after surgery for congenital anorectal malformation (CARM), not all patients achieve satisfactory continence. Therefore, identifying which individuals will benefit from this method is crucial. Methods: A prospective cohort study enrolled 92 children with FI. All patients underwent tSNS with PFE treatment, and an improved outcome was defined as a Wexner score ≤4. A predictive model to identify the effects of tSNS with PFEs in FI was developed based on the analysis of magnetic resonance imaging and high-resolution anorectal manometry with the area under the receiver operating characteristic curve (AUC) to evaluate the predictive value of external anal sphincter (EAS) thickness index and anal squeezing pressure (ASP). Results: tSNS with PFEs improved outcomes in 72 patients and led to poor outcomes in 20 (4 had their rectums deviate from the puborectalis muscle centre or puborectal muscle ruptures, while 16 lacked EAS with a lower ASP). The AUCs for the EAS thickness index and ASP in predicting tSNS with PFEs effects were 0.915 (95%CI 0.846–0.983, P=0.000) and 0.886 (95%CI 0.819–0.952, P=0.000), respectively. By applying cutoff values of 0.076 for the EAS thickness index and 21.95mmHg for ASP, tSNS with PFEs was found to be ineffective. Conclusions: tSNS with PFEs is effective for most FI patients after CARM surgery except when rectum deviates from the puborectal muscle centre, puborectal muscle rupture occurs, or EAS is absent with a low ASP.

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Section: Introductionmentioning

confidence: 99%

A Predictive Model to Identify the Effects of Transcutaneous Sacral Nerve Stimulation With Pelvic Floor Exercises in Fecal Incontinence After Surgery for Anorectal Malformation

Shen,

Zhang,

Tao

et al. 2023

Am J Gastroenterol

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“… 13 , 15 - 18 This condition, which causes serious problems for patients in their daily routine should be treated in every possible case to increase the quality of life. 16 Therefore, it is important for pediatricians to have knowledge about the management of constipation and fecal incontinence of ARM patients.…”

Section: Introductionmentioning

confidence: 99%

Anorectal Malformations and Late-Term Problems

Hakalmaz

Tekant

2023

Turk Arch Pediatrics

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Anorectal malformation is a disease with different subtypes and anatomical and functional multisystemic involvement that requires a unique approach in each age group. Anomalies associated with vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities (VACTERL) association require detailed investigation and management. Beginning from the neonatal period, treatment is carried out with different surgical procedures. The clinical course of these patients may be associated with medical problems, accompanying congenital anomalies, perioperative management, or late sequelae. Constipation and fecal–urinary incontinence are the most common problems encountered in long-term follow-up. Renal failure is the most important cause of long-term mortality. In addition, these patients need to be under control until adulthood due to cardiological, spinal, genital, gynecological, and endocrine problems. In this follow-up, many pediatric disciplines such as neonatal intensive care, cardiology, nephrology, gastroenterology, and endocrinology cooperate with pediatric surgeons and pediatric urologists.

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Long-term (> 10 years) bowel function of anorectal malformations: a retrospective single-center study

Wang,

Peng,

Pang

et al. 2024

Pediatr Surg Int

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Long‐Term Functional Outcomes of an Anorectal Malformation French National Cohort

Cited by 6 publications

References 22 publications

A Predictive Model to Identify the Effects of Transcutaneous Sacral Nerve Stimulation With Pelvic Floor Exercises in Fecal Incontinence After Surgery for Anorectal Malformation

A Predictive Model to Identify the Effects of Transcutaneous Sacral Nerve Stimulation With Pelvic Floor Exercises in Fecal Incontinence After Surgery for Anorectal Malformation

Anorectal Malformations and Late-Term Problems

Long-term (> 10 years) bowel function of anorectal malformations: a retrospective single-center study

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