Summary Introduction: Patients operated for correction of anorectal malformations (ARM) can develop fecal incontinence, constipation, and soiling, with loss in quality of life. Objective: To evaluate, through the use of questionnaires, fecal continence, and quality of life of children in the late postoperative follow-up of ARM correction, both high and low. In addition, the levels of fecal continence and quality of life were compared with those of a control group. Method: A Fecal Continence Index Questionnaire (ICF) and a Questionnaire for Assessment of Quality of Life Related to Fecal Continence in Children and Adolescents (QQVCFCA) were administered to 63 patients with ARM, aged from 7 to 19 years, whose surgical treatment had been completed for at least 6 months. The patients were compared to a control group of 59 children. Results: In the control group, 25 (42.4%) patients had good continence and 34 (57.6%), normal continence. We found that the quality of life in children with ARM is compromised globally, in all areas and in the ICF questionnaire, compared to controls (p<0.001). There was no difference between patients with high and low defects. Thirty-two (50.8%) patients had other associated anomalies. Conclusion: In patients operated for ARM correction, quality of life and ICF were compromised, and there was no difference between patients with high-type and low-type of the disease. In about half the cases there are other associated malformations.
Objective:Surgical treatment of anorectal malformations (ARMs) and Hirschsprung's disease
(HD) leads to alterations in bowel habits and fecal incontinence, with consequent
quality of life impairment. The objectives were to create and validate a
Questionnaire for the Fecal Incontinence Index (FII) based on the Holschneider
score, as well as a Questionnaire for the Assessment of Quality of Life Related to
Fecal Incontinence in Children and Adolescents (QQVCFCA), based on the Fecal
Incontinence Quality of Life.Methods:The questionnaires were applied to 71 children submitted to surgical procedure, in
two stages. Validity was tested by comparing the QQVCFCA and a generic quality of
life questionnaire (SF-36), and between QQVCFCA and the FII. A group of 59 normal
children was used as control.Results:At two stages, 45.0% (32/71) and 42.8% (21/49) of the patients had fecal
incontinence. It was observed that the QQVCFCA showed a significant correlation
with the SF-36 and FII (Pearson's correlation 0.57), showing that the quality of
life is directly proportional to improvement in fecal incontinence. Quality of
life in patients with fecal incontinence is still globally impaired, when compared
with control subjects (p<0.05, Student's
t-test). There were also significant differences between the
results of children with ARMs and children with HD.Conclusions:QQVCFCA and FII are useful tools to assess the quality of life and fecal
incontinence in these groups of children. Children with ARMs submitted to surgical
procedure and HD have similar quality of life impairment.
QQVCFCA and FII are useful tools to assess the quality of life and fecal incontinence in these groups of children. Children with ARMs submitted to surgical procedure and HD have similar quality of life impairment.
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