DO CHILDREN WITH REPAIRED LOW ANORECTAL-MALFORMATIONS HAVE NORMAL BOWEL FUNCTION

Citation
Rj. Rintala et al., DO CHILDREN WITH REPAIRED LOW ANORECTAL-MALFORMATIONS HAVE NORMAL BOWEL FUNCTION, Journal of pediatric surgery, 32(6), 1997, pp. 823-826
Citations number
11
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pediatrics,Surgery
ISSN journal
0022-3468
Volume
32
Issue
6
Year of publication
1997
Pages
823 - 826
Database
ISI
SICI code
0022-3468(1997)32:6<823:DCWRLA>2.0.ZU;2-9
Abstract
Purpose: The authors' aim was to compare bowel function in patients wh o had undergone repair of a low anorectal malformation with that of no rmal healthy children. Methods: The bowel function of 40 patients (29 boys, 11 girls; median age, 7; range, 3 to 13) with low anorectal malf ormations was evaluated by a multivariate scoring method based on a qu estionnaire. All patients were toilet trained for defecation and mictu rition. They were also evaluated clinically, and the outcome was grade d as excellent (normal bower function), good (no or minor social limit ations), fair (marked social limitations), or poor (total incontinence ). Fifty-four healthy children with a similar age and gender distribut ion were used as controls. Results: Twenty-one patients (52%) with nor mal bower function had continence scores within the range of the score s of healthy children (patients, 19.3 +/- 0.7 v controls, 19.1 +/- 1.3 ). Fifteen patients had a good clinical outcome. The mean score in thi s group was 16.3 +/- 2.4, Four patients with a fair outcome had a mean score of 10.5 +/- 2.9. Constipation requiring dietary or medical trea tment was reported by 17 patients (42%) end four of the controls (7%). Daily soiling caused by fecal overflow was reported by four patients (10%) and none of the controls. None of the patients had urinary incon tinence; occasional wetting was found in 27% of the patients and 22% o f the controls (P=.56). Conclusion: Only half of the children with a l ow anorectal malformation have age-appropriate normal bower function. Long-term follow-up of these patients to manage the main functional pr oblem, constipation, is warranted. Copyright (C) 1997 by W.B. Saunders Company.