Preliminary report on the International Conference for the Development of Standards for the Treatment of Anorectal Malformations

Holschneider, A. M.; Hutson, John M.; Peña, A Ochoa de la; Beket, Elhamy; Chatterjee, Subir K.; Coran, Arnold G.; Davies, M.R.Q.; Georgeson, Keith E.; Grosfeld, Jay L.; Gupta, Devendra K.; Iwai, Naoharu; Kluth, Dirk; Martucciello, G.; Moore, Samuel W.; Rintala, Risto J.; Smith, Edward D.; Sripathi, D.V.; Stephens, Douglas; Sen, Sudipta; Ure, Benno M.; Grasshoff, Sabine; Boemers, Thomas M.; Murphy, Feilim; Söylet, Yunus; Dübbers, Martin; Kunst, Marc

doi:10.1016/j.jpedsurg.2005.08.002

Cited by 545 publications

(393 citation statements)

References 6 publications

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“…Moreover, as noted by Wijers et al, detailed definitive diagnosis according to the Krickenbeck criteria are often not denoted, and that together with possible misdiagnoses may account for some of the 'unknown' diagnoses in the South African arm of this study [9,22,28]. Of interest is that although the Italian establishment had treated fewer patients than the two South African centers, the relative percentage of the types of ARM diagnosed in males was not significantly different.…”

Section: Discussionmentioning

confidence: 60%

“…ARMs may be classified according to the internationally recognized Krickenbeck classification [9]. This allows for uniform reporting and comparisons, in males and females, based on the number of orifices visible in the perineum (females) and on fistula location (males) [9].…”

Section: Introductionmentioning

confidence: 99%

“…This allows for uniform reporting and comparisons, in males and females, based on the number of orifices visible in the perineum (females) and on fistula location (males) [9]. Associate malformations are present in 45-65 % of neonates with ARMs, and include urogenital, cardiac, vertebral, spinal and gastrointestinal abnormalities most commonly [10,11].…”

Section: Introductionmentioning

confidence: 99%

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Comparison in the incidence of anorectal malformations between a first- and third-world referral center

et al. 2015

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Purpose Aim of study was to evaluate the differences in incidence and presentation of anorectal malformations (ARMs) between selected Pediatric Surgery Divisions in the Republic of South Africa (ZAR) and Italy. Methods A retrospective cohort study involved analysis of clinical records of patients with ARM born between 2005 and 2012. Type of ARM, maternal age, birth weight, gestational age, presence of associated anomalies and delayed diagnosis were analyzed. Results 335 patients were included in this study. Of note, statistically significant differences between the African and European patient groups were observed in a male predominance in the ZAR patient population. In addition, female recto-perineal fistulas were diagnosed in significantly more Italian patients than in ZAR. Furthermore, a more advanced maternal age and a lower gestational age was noted in the European cohort with a minimal delay in initial diagnosis as opposed to the African counterpart. Both centers reported recto-perineal fistula as the most common malformation in male patients. Conclusion With the exception of perineal fistulas in females, the incidence of specific subtypes of ARMs was similar in the two groups. This may be of importance when extrapolating European study conclusion to the South African setting.

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Section: Discussionmentioning

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison in the incidence of anorectal malformations between a first- and third-world referral center

et al. 2015

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“…17 Author measure the functional outcome of ARM by most recent krickenburg classification, this include three parameters: voluntary bowel movements(VBM) (yes/no), soiling (yes/no, if yes grade 1-3), and constipation (yes/no, if yes grade 1-3).…”

Section: Patel Jl Et Al Int Surg J 2018 Apr;5(4):1286-1290mentioning

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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“…[4] However, the outcome of the surgery of these conditions often remains unsatisfactory. [5,6] This may partly be due to nonavailability of functional studies in terms of contractility of intestinal smooth muscles because most of the studies so far conducted on these disorders were focused on histology and immunohistochemistry. [7,8] Available histopathological studies [9] demonstrated abnormalities in colonic muscle and neuronal components in congenital pouch colon while another group of workers reported no structural deficiency.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of in vitro contractility between gut tissues of Hirschsprung's disease and other gut malformations

Tiwari¹,

Singh²,

Pandey³

et al. 2017

Natl J Physiol Pharm Pharmacol

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Background: Hirschsprung's disease and other gut malformations commonly present with obstructive features of gut in pediatric age group. Problem of obstruction persists even after resection and anastomosis operation. Aims and Objectives: This in vitro comparative study was performed to assess the gut contractility to chemical mediators such as Acetylcholine and Histamine between Hirschsprung's disease and other gut malformations. Materials and Methods: The longitudinal muscle strips of Hirschsprung's cases and other gut malformations (non-Hirschsprung's cases) were placed in Dales organ bath containing Krebs-Ringer solution, continuously bobbled with 100% O2 at 28°C. Gut contractions were recorded using Power Lab 4/ST system and was analyzed using software CHART-5 for windows. Control contractions were recorded against initial tension of 0.5 g. Subsequently, agonist (acetylcholine, histamine)-induced contractions were recorded before and after appropriate antagonists (atropine, pheniramine). Before values of agonist-induced contractions of Hirschsprung and non-Hirschsprung's cases were compared. Values of agonistinduced contractions obtained after pretreatment with antagonists were also compared between Hirschsprung and nonHirschsprung's cases. Results: Acetylcholine enhanced contractions in non-Hirschsprung's cases and it caused small increase in amplitude of contractions in Hirschsprung's cases. Atropine pretreatment blocked acetylcholine-induced contractions significantly in non-Hirschsprung's cases, whereas it failed to block in the Hirschsprung's cases. Histamine augmented contractions in both Hirschsprung and non-Hirschsprung's cases. H1 antagonist, pheniramine failed to block the contractility in both the cases. Conclusion: Findings of this study suggested that acetylcholine increased gut contractility significantly in non-Hirschsprung's cases involving muscarinic-cholinergic pathways, whereas histamine increased gut contractility in both Hirschsprung's disease and non-Hirschsprung's cases and it is not mediated by H1 receptors.

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Preliminary report on the International Conference for the Development of Standards for the Treatment of Anorectal Malformations

Cited by 545 publications

References 6 publications

Comparison in the incidence of anorectal malformations between a first- and third-world referral center

Comparison in the incidence of anorectal malformations between a first- and third-world referral center

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

A comparative study of in vitro contractility between gut tissues of Hirschsprung's disease and other gut malformations

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