bowel symptoms in children with anorectal malformation a
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Bowel symptoms in children with anorectal malformation afollow-up with a gender and age perspective(Journal of Pediatric Surgery-2014
Lund University, SwedenOslo University, Norway
Mosher Munda
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Background
Bowel control in a newbornchild with an
anorectal malformation (ARM)
Bowel function in children with ARM operated on
with posterior sagittal anorectal plasty (PSARP)
different classification and follow up systems
True outcome
The !rickenbeck classification system"##$
none of the pre%ious reports ha%e analy&ed gender'specific outcome
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Aim
Primaryto describe bowel function according
to the !rickenbeck follow'up system separately
for females and males *+" years old with ARM
SecondaryTo e%aluate if fecal incontinence and
constipation were less fre,uent in the older age
group
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Materials and method
Children with anorectal malformation (ARM)referred to two tertiary centers for ediatricsur!ery in two countries durin! the eriods from"anuary #$$% and "anuary &''', resectively,until ecemer &''%
children were etween * and #& years of a!e
+cluded anal stenosis, rectal atresia andcloaca, oerated on at other centers and thosewho had mi!rated
-' and .. children, resectively
#/. children,0- females and %# males
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Materials and method
-peration methods and follow'up
PSARP'procedure. described by /r Pena
-peration methods and follow'up
The anal sphincter comple0 is defined byelectromyostimulation
A di%erting colostomy is used for males with
rectourinary fistulas or no fistula. and for some of
the females with %estibular fistulas and those with
no fistula
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Materials and method
1linical follow'up and is both descripti%e and
comparati%e
!rickenbeck post'operati%e follow'up scheme
the outcome The outcome was measured before bowel
management was introduced
Se%ere incontinence was defined as !rickenbeck
grade " and 2
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Statistical considerations
The e0act !ruskal*3allis test
4enerali&ed 5isher6s e0act test was used for
dichotomous outcomes between all groups
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Results
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Results
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Results
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