Anorectal malformations with good prognosis: Variables affecting the functional outcome

Rossella Arnoldi, Francesco MacChini, Valerio Gentilino, Giorgio Farris, Anna Morandi, Giulia Brisighelli, Ernesto Leva

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Backgroud/Purpose The purpose of this study was to investigate the outcome of patients operated for anorectal malformations (ARMs) with good prognosis. Methods Thirty patients underwent clinical evaluation by Rintala score and anorectal manometry recording anal resting pressure (ARP), rectoanal inhibitory reflex (RAIR), and rectal volume (RV). The results were analysed with regard to sex, type of ARM, surgical timing of posterior sagittal anorectoplasty (PSARP), neurospinal cord dysraphism (ND), neonatal colostomy, and institution where they underwent surgery. Results 6/30 (20%) presented ND despite normal sacrum. 17/30 (57%) patients had a normal Rintala score. ND and neonatal colostomy were significantly associated with a pathologic score (p = 0.0029 and p = 0.0016). Patients with ND had significantly lower ARP compared to patients with normal spine (23.5 ± 7.2 mmHg vs 32 ± 7.9 mmHg, p = 0.023). ARP was significantly lower in patients with neonatal colostomy compared to patients with primary repair (25.22 ± 10.24 mmHg vs 32.57 ± 6.68 mmHg, p = 0.026). RAIR was present in only 2/6 (33%) patients with ND, while in 21/24 (87.5%) without ND (p = 0.015) and in 4/9 (44%) patients with neonatal colostomy, while in 19/21 (90.5%) patients submitted to primary repair (p = 0.014). Conclusions Neurospinal cord dysraphism may be present despite normal sacral ratio. From a clinical point of view, patients with good prognosis ARMs are not completely comparable to healthy children. Neurospinal cord dysraphism and neonatal colostomy seem to worsen the clinical and manometric (ARP and RAIR) outcomes of these patients.

Original languageEnglish
Pages (from-to)1232-1236
Number of pages5
JournalJournal of Pediatric Surgery
Volume49
Issue number8
DOIs
Publication statusPublished - 2014

Fingerprint

Colostomy
Reflex
Pressure
Anorectal Malformations
Sacrum
Manometry
Spine

Keywords

  • Anorectal malformation
  • Anorectal manometry
  • Functional outcome

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

Anorectal malformations with good prognosis : Variables affecting the functional outcome. / Arnoldi, Rossella; MacChini, Francesco; Gentilino, Valerio; Farris, Giorgio; Morandi, Anna; Brisighelli, Giulia; Leva, Ernesto.

In: Journal of Pediatric Surgery, Vol. 49, No. 8, 2014, p. 1232-1236.

Research output: Contribution to journalArticle

Arnoldi, Rossella ; MacChini, Francesco ; Gentilino, Valerio ; Farris, Giorgio ; Morandi, Anna ; Brisighelli, Giulia ; Leva, Ernesto. / Anorectal malformations with good prognosis : Variables affecting the functional outcome. In: Journal of Pediatric Surgery. 2014 ; Vol. 49, No. 8. pp. 1232-1236.
@article{62941241504c4154a4a166bad33c7a62,
title = "Anorectal malformations with good prognosis: Variables affecting the functional outcome",
abstract = "Backgroud/Purpose The purpose of this study was to investigate the outcome of patients operated for anorectal malformations (ARMs) with good prognosis. Methods Thirty patients underwent clinical evaluation by Rintala score and anorectal manometry recording anal resting pressure (ARP), rectoanal inhibitory reflex (RAIR), and rectal volume (RV). The results were analysed with regard to sex, type of ARM, surgical timing of posterior sagittal anorectoplasty (PSARP), neurospinal cord dysraphism (ND), neonatal colostomy, and institution where they underwent surgery. Results 6/30 (20{\%}) presented ND despite normal sacrum. 17/30 (57{\%}) patients had a normal Rintala score. ND and neonatal colostomy were significantly associated with a pathologic score (p = 0.0029 and p = 0.0016). Patients with ND had significantly lower ARP compared to patients with normal spine (23.5 ± 7.2 mmHg vs 32 ± 7.9 mmHg, p = 0.023). ARP was significantly lower in patients with neonatal colostomy compared to patients with primary repair (25.22 ± 10.24 mmHg vs 32.57 ± 6.68 mmHg, p = 0.026). RAIR was present in only 2/6 (33{\%}) patients with ND, while in 21/24 (87.5{\%}) without ND (p = 0.015) and in 4/9 (44{\%}) patients with neonatal colostomy, while in 19/21 (90.5{\%}) patients submitted to primary repair (p = 0.014). Conclusions Neurospinal cord dysraphism may be present despite normal sacral ratio. From a clinical point of view, patients with good prognosis ARMs are not completely comparable to healthy children. Neurospinal cord dysraphism and neonatal colostomy seem to worsen the clinical and manometric (ARP and RAIR) outcomes of these patients.",
keywords = "Anorectal malformation, Anorectal manometry, Functional outcome",
author = "Rossella Arnoldi and Francesco MacChini and Valerio Gentilino and Giorgio Farris and Anna Morandi and Giulia Brisighelli and Ernesto Leva",
year = "2014",
doi = "10.1016/j.jpedsurg.2014.01.051",
language = "English",
volume = "49",
pages = "1232--1236",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",
number = "8",

}

TY - JOUR

T1 - Anorectal malformations with good prognosis

T2 - Variables affecting the functional outcome

AU - Arnoldi, Rossella

AU - MacChini, Francesco

AU - Gentilino, Valerio

AU - Farris, Giorgio

AU - Morandi, Anna

AU - Brisighelli, Giulia

AU - Leva, Ernesto

PY - 2014

Y1 - 2014

N2 - Backgroud/Purpose The purpose of this study was to investigate the outcome of patients operated for anorectal malformations (ARMs) with good prognosis. Methods Thirty patients underwent clinical evaluation by Rintala score and anorectal manometry recording anal resting pressure (ARP), rectoanal inhibitory reflex (RAIR), and rectal volume (RV). The results were analysed with regard to sex, type of ARM, surgical timing of posterior sagittal anorectoplasty (PSARP), neurospinal cord dysraphism (ND), neonatal colostomy, and institution where they underwent surgery. Results 6/30 (20%) presented ND despite normal sacrum. 17/30 (57%) patients had a normal Rintala score. ND and neonatal colostomy were significantly associated with a pathologic score (p = 0.0029 and p = 0.0016). Patients with ND had significantly lower ARP compared to patients with normal spine (23.5 ± 7.2 mmHg vs 32 ± 7.9 mmHg, p = 0.023). ARP was significantly lower in patients with neonatal colostomy compared to patients with primary repair (25.22 ± 10.24 mmHg vs 32.57 ± 6.68 mmHg, p = 0.026). RAIR was present in only 2/6 (33%) patients with ND, while in 21/24 (87.5%) without ND (p = 0.015) and in 4/9 (44%) patients with neonatal colostomy, while in 19/21 (90.5%) patients submitted to primary repair (p = 0.014). Conclusions Neurospinal cord dysraphism may be present despite normal sacral ratio. From a clinical point of view, patients with good prognosis ARMs are not completely comparable to healthy children. Neurospinal cord dysraphism and neonatal colostomy seem to worsen the clinical and manometric (ARP and RAIR) outcomes of these patients.

AB - Backgroud/Purpose The purpose of this study was to investigate the outcome of patients operated for anorectal malformations (ARMs) with good prognosis. Methods Thirty patients underwent clinical evaluation by Rintala score and anorectal manometry recording anal resting pressure (ARP), rectoanal inhibitory reflex (RAIR), and rectal volume (RV). The results were analysed with regard to sex, type of ARM, surgical timing of posterior sagittal anorectoplasty (PSARP), neurospinal cord dysraphism (ND), neonatal colostomy, and institution where they underwent surgery. Results 6/30 (20%) presented ND despite normal sacrum. 17/30 (57%) patients had a normal Rintala score. ND and neonatal colostomy were significantly associated with a pathologic score (p = 0.0029 and p = 0.0016). Patients with ND had significantly lower ARP compared to patients with normal spine (23.5 ± 7.2 mmHg vs 32 ± 7.9 mmHg, p = 0.023). ARP was significantly lower in patients with neonatal colostomy compared to patients with primary repair (25.22 ± 10.24 mmHg vs 32.57 ± 6.68 mmHg, p = 0.026). RAIR was present in only 2/6 (33%) patients with ND, while in 21/24 (87.5%) without ND (p = 0.015) and in 4/9 (44%) patients with neonatal colostomy, while in 19/21 (90.5%) patients submitted to primary repair (p = 0.014). Conclusions Neurospinal cord dysraphism may be present despite normal sacral ratio. From a clinical point of view, patients with good prognosis ARMs are not completely comparable to healthy children. Neurospinal cord dysraphism and neonatal colostomy seem to worsen the clinical and manometric (ARP and RAIR) outcomes of these patients.

KW - Anorectal malformation

KW - Anorectal manometry

KW - Functional outcome

UR - http://www.scopus.com/inward/record.url?scp=84905505443&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84905505443&partnerID=8YFLogxK

U2 - 10.1016/j.jpedsurg.2014.01.051

DO - 10.1016/j.jpedsurg.2014.01.051

M3 - Article

C2 - 25092082

AN - SCOPUS:84905505443

VL - 49

SP - 1232

EP - 1236

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

IS - 8

ER -