The Clinical and Radiological Assessment of Anal Continence in Childhood

Kelly, Justin H.

doi:10.1111/j.1445-2197.1972.tb06743.x

Cited by 86 publications

(51 citation statements)

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“…The mean Kelly's score [14] among our cases was 5.58 indicating good continence. On the other hand, constipation, which was a major contributing factor in our cases, improved postoperatively in cases presented with constipation and it did not complicate any of our cases postoperatively.…”

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confidence: 46%

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Evaluation of laparoscopic rectosigmoidopexy for the treatment of complete rectal prolapse in children

Mokhtar¹,

Abouheba²,

Shehata³

2017

MIS

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Aim:Rectal prolapse in children is a common condition in infancy and early childhood that usually responds to conservative measures. Surgery is reserved only for resistant cases that fail to respond to conservative measures. This study was designed to evaluate the efficacy of 3-point fixation concept (retrorectal dissection, rectopexy to presacral fascia of the sacral promontory and sigmoidopexy onto the anterior abdominal wall) in treatment of complete rectal prolapse in children using laparoscopy. Methods: This prospective study was conducted on 12 children with persistent complete rectal prolapse who failed to respond to adequate conservative measures from July 2015 to July 2016. The technical details of the procedure are described. Patients were followed up for at least 6 months and were assessed clinically and radiologically for continence and constipation using the appropriate scoring systems. Results: Twelve patients were included, 8 females and 4 males, laparoscopic rectopexy and sigmoidopexy were done for all cases. The mean duration for surgery was 58.42 min. No intraoperative complications recorded. One case (8.3%) had partial thickness recurrence and 1 case had skin stitch sinus. No postoperative constipation nor incontinence was observed. Conclusion:The laparoscopic rectopexy and sigmoidopexy is an effective approach for the treatment of refractory complete rectal prolapse in children. The 3-point fixation proved efficient in controlling rectal prolapse in children with minimal complications. Key words:Laparoscopy, rectopexy, sigmoidopexy, rectal prolapse, children, 3-point fixation ABSTRACTArticle history: Received: 20-12-2016 Accepted: 07-03-2017 Published: 31-03-2017 Prof. Sameh Shehata is working as professor and past chairman of Pediatric Surgery Department, Faculty of Medicine, University of Alexandria, Egypt. He is the past president of the Egyptian Association of Pediatric Surgeons. He has a wide international activity in the field of pediatric surgery; he is the president-elect of the WOFAPS, and the cochairman of the IPEG middle east chapter. He has given over 150 lectures both nationally and internationally and was invited as a guest lecture in many national associations congresses. He is among the editorial board of many national and international pediatric surgery journals including the JPS, PSI and International Journal of Urology.

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confidence: 46%

“…Incontinence didn't complicate any of our cases during the follow-up. The mean Kelly's score [14] was 5.58 ± 0.51 (range 5-6). Barium enema was done for all cases in our study 1 month after surgery and showed no colonic dilatation and no residual barium in their bowel [ Figure 5].…”

Section: Resultsmentioning

confidence: 99%

Evaluation of laparoscopic rectosigmoidopexy for the treatment of complete rectal prolapse in children

Mokhtar¹,

Abouheba²,

Shehata³

2017

MIS

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“…A number of clinical scoring system are currently in use to assess the functional and stooling pattern of children with ARM and HD. 12 The stooling outcome that we employed in this study were done using the recently proposed Krickenbeck scoring system. Though this was proposed for anorectal malformation, it has also been used in the evaluation of cases of HD.…”

Section: Discussionmentioning

confidence: 99%

“…Martin and Altemeir and Martin and Caudill described careful clamp placement to entirely eliminate the rectal pouch. 12 Use of stapling devices for the colorectal anastomosis facilitate division of the common rectal wall.…”

Section: Introductionmentioning

confidence: 99%

Assessment of functional outcome in patients of Hirschprung’s disease following two stages Duhamel pull through

2020

IJMPO

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Purpose: The aim of this study was to assess the functional outcome in patients of Hirschprung's disease (HD) following two stages Duhamel pull through operation, that is levelling colostomy followed by the pull through. Materials and Methods: The study was conducted in the Department of Pediatric Surgery of a busy tertiary care children's hospital. Patients who completed the two stage Duhamel pull through operation at least 6 months prior and aged more than three years were included in the study. The quality of life (QOL) was assessed by using a questionnaire to the parents and clinical examination of the child. Continence status was assessed by applying the Krickenbeck Score.

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“…12 The Kelly score introduced a quantitative scoring system based on functional and objective criteria. 13 Later, Holschneider and Metzer built on the concept of quantitative clinical scoring and added manometric parameters to the evaluation. 14 The Wingspread Score approaches the problem from a slightly different angle by gauging the functional outcome from the degree of therapy required for symptom control.…”

Section: Discussionmentioning

confidence: 99%

Assessment of post-surgical functional outcome in children with anorectal malformation

Patel¹,

Ma²,

Sharma³

et al. 2018

Int Surg J

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Background: Anorectal malformations (ARMs) comprise a spectrum of congenital anomalies that continue to present a challenge for paediatric surgeons. Advances in modern surgical techniques and neonatal care have greatly improved survival among ARM patients over the last decades, and early mortality is now unusual in the absence of fatal associated cardiac or chromosomal defects. The aim of this study is to measure the functional outcome of ARM by most recent krickenburg classification.Methods: The present longitudinal study was conducted in Department of paediatric surgery, Dr. BRAM hospital, Raipur, Chhattisgarh during study period February 2016 to September 2017. Those patients who had completed their all stages of surgery for anorectal malformation at-least 6 months back and arriving at outpatient department of paediatric surgery were included.Results: Maximum number of patients were in age group of 3 to 5 years (77.8%) and minimum were 9 to 11 years (3.7%). A 50.6% male and 49.4% female child were included in the study. Maximum number of patients had vestibular fistula (38.27% followed by perineal fistula (24.69%), rectobulbar (18.51%) then rectovaginal (7.4%) and rectoprostatic (7.4%). Minimum patients had pouch colon (2.4%) and cloaca (1.09%). Voluntary bowel movement was present in 50% of rectoprostatic and 66.6% of rectovaginal fistula. Eighty percentage rectobulbar and 83.87% vestibular fistula had voluntary bowel movement. Cloaca and Pouch colon had no voluntary bowel movement. In recto-vaginal fistula 66.6% had soiling, of which 50% had grade 1 and 16.6% had grade 2 soiling. In recto-bulbar fistula 40% cases had soiling, out of which 20% had grade1 and 20% had grade 2. In recto-vaginal fistula cases 33 % had constipation, of which 16.5% had grade 1 and 16.6 % had grade 2. In recto-prostatic fistula 16% had constipation which was grade1.Conclusions: In this study, author showed that functional outcomes comparable to matched peers are achieved in the majority of low ARMs after minimally invasive, individualized perineal procedures and regular surgical follow-up. In high type of ARM soiling is the prominent feature while in intermediate ARM constipation is more common.

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The Clinical and Radiological Assessment of Anal Continence in Childhood

Cited by 86 publications

References 1 publication

Evaluation of laparoscopic rectosigmoidopexy for the treatment of complete rectal prolapse in children

Evaluation of laparoscopic rectosigmoidopexy for the treatment of complete rectal prolapse in children

Assessment of functional outcome in patients of Hirschprung’s disease following two stages Duhamel pull through

Assessment of post-surgical functional outcome in children with anorectal malformation

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