Long-term outcome of anorectal malformations: the patient perspective

Abstract

To assess the long-term outcome of surgery for anorectal malformations (ARM) from the patient's perspective. One hundred and sixty seven children were operated for ARM between 1982 and 2000. Disease impact questionnaires to assess both clinical and psychological outcomes were sent to 137 eligible families. Statistical analysis was performed using SPSS version 11.5. The response rate was 61% (n=84). Sixty six percent had soiling. There was no significant difference in the incidence of soiling between genders or between the younger child and adolescent. Soiling was significantly increased in high (86%) and intermediate (79%) compared to low (43%) malformation (P=0.001). Constipation was seen in 62% and abdominal pain in 49%, with no significant difference between malformation levels. Overall, 71% had associated anomalies. Although 44% had a documented urological abnormality, clinical significant problems were seen in only 30%. Eighty percent of the children had one or more behavioural problems and 15% expressed suicidal thoughts. ARM had a negative impact on the social life of the child in 52% and on family functioning in 50%. Soiling (P=0.000), presence of associated anomalies (P=0.001), constipation (P=0.005), level of ARM (P=0.015) and abdominal pain (P=0.039) correlated significantly with psychosocial morbidity. Despite these findings, 62% of adolescents and 71% of children below 12 years with their parents reported above average global hopefulness score, remaining hopeful for the future. Children with ARM have ongoing physical and social morbidity, indicating the need for continuing multidisciplinary review and support to optimise their quality of life.

Adaptation und Lebensqualität bei anorektaler Malformation: Empirische Befunde, theoretisches Modell, psychodiagnostische Erfassung und verhaltensmedizinische Intervention

“…Die Studie von Hamid et al (2007) belegt auch eine ausgeprägte psychosoziale Belastungssituation bzw. psychopathologische Komorbidität: 80 % der Patienten bzw.…”

Diagnostic de la constipation chez l’enfant

“…Le risque augmente en cas de forme anorectale haute associée à des anomalies sacrées et médullaires [57] . Par exemple, la continence est considérée comme socialement normale dans 75-85% des cas de malformations basses et dans seulement 50% après traitement de malformations anorectales hautes.…”

Diagnóstico del estreñimiento en niños

“…El riesgo aumenta en casos con forma anorrectal alta asociada a anomalías sacras y medulares [57] . Por ejemplo, la continencia se considera socialmente normal en el 75 al 85% con malformaciones inferiores y sólo en el 50% tras el tratamiento de malformaciones anorrectales superiores.…”