"Assessing the benefit of reoperations in patients who suffer from feca" by Richard J. Wood, Devin R. Halleran et al.
 

Assessing the benefit of reoperations in patients who suffer from fecal incontinence after repair of their anorectal malformation

Document Type

Journal Article

Publication Date

1-1-2020

Journal

Journal of Pediatric Surgery

DOI

10.1016/j.jpedsurg.2020.06.011

Keywords

Anorectal malformation; Fecal continence; Imperforate anus; Incontinence; PSARP; Redo posterior sagittal anorectoplasty

Abstract

© 2020 Elsevier Inc. Background and Aim: Patients with a previously repaired anorectal malformation (ARM) can suffer from complications which lead to incontinence. Reoperation can improve the anatomic result, but its impact on functional outcomes is unclear. Methods: We performed a retrospective cohort study of patients with a previously repaired ARM who underwent redo PSARP at our Center and compared results at initial assessment and 12 months after redo. Results: One hundred fifty-three patients underwent a redo PSARP for anoplasty mislocation (n = 93, 61%), stricture (n = 55, 36%), remnant of the original fistula (n = 28, 18%), or rectal prolapse (n = 11, 7%). Post-redo complications included stricture (n = 33, 22%) and dehiscence (n = 5, 3%). At 1-year post-redo, 75/153 (49%) are on laxatives only, of whom 57 (76%) are continent of stool. Of the remaining 78 (51%) patients, 61 (78%) are clean (≤ 1 accident per week) on enemas. Interestingly, 16/79 (20%) of patients with expected poor continence potential were continent of stool on laxatives. Overall, 118/153 (77%) are clean after their redo. Quality of life (76.7 vs. 83.8, p = 0.05) and Baylor continence (29.2 vs. 17.7, p =<0.0001) scores improved. Conclusion: Patients with fecal incontinence after an ARM repair can, with a reoperation, have their anatomy corrected which can restore continence for many, and improve their quality of life. Level of Evidence: IV. Type of study: Retrospective cohort study.

This document is currently not available here.

Plum Print visual indicator of research metrics
PlumX Metrics
  • Citations
    • Citation Indexes: 24
  • Usage
    • Abstract Views: 7
  • Captures
    • Readers: 52
see details

Share

COinS