Comparing Consistency and Usability of Common Bowel Function Scoring Systems in Anorectal Malformation Patients.

Autor: Shaari MK; Division of Paediatric Surgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia., Tan YW; Division of Paediatric Surgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Division of Paediatric Surgery, Department of Surgery, University of Malaya Medical Centre, Kuala Lumpur, Malaysia., Abdullah MY; Department of Paediatric Surgery, Hospital Tunku Azizah, Kuala Lumpur, Malaysia., Sharudin MF; Division of Paediatric Surgery, Department of Surgery, Hospital Sultanah Aminah, Johor, Malaysia., Osman M; Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia., Teoh THQ; Division of Paediatric Surgery, Department of Surgery, Hospital Pulau Pinang, Pulau Pinang, Malaysia., Lim CJ; Department of Orthopaedic Surgery, Woodlands Health, Singapore., Nah SA; Division of Paediatric Surgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Division of Paediatric Surgery, Department of Surgery, University of Malaya Medical Centre, Kuala Lumpur, Malaysia. Electronic address: shireen.nah@um.edu.my.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2024 Apr; Vol. 59 (4), pp. 571-576. Date of Electronic Publication: 2023 Dec 07.
DOI: 10.1016/j.jpedsurg.2023.12.002
Abstrakt: Background: Assessment of postoperative bowel function in anorectal malformation (ARM) patients is crucial for benchmarking outcomes. We compared existing bowel function scoring systems in various aspects in patients with ARM.
Methods: With ethical approval, this was a cross-sectional study involving 5 paediatric surgery referral centres in Malaysia, comparing the Kelly, Japanese Study Group of Anorectal Anomalies (JSGA), Holschneider and Krickenbeck bowel function questionnaires. We recruited patients aged 4-17 years, who had completed definitive surgery & stoma closure (where relevant) > 12 months prior to participation. We standardised outcomes of each scoring system into categories ('good', 'fair', 'poor' and 'very poor') to facilitate comparison. Parents & patients were surveyed and asked to rate the ease of understanding of each questionnaire. The difference in protocol scores rated between parents and patients were compared. Association of each bowel function scoring protocol with type of anomaly was assessed. Statistical significance was p < 0.05.
Results: Thirty-nine parents (21 mothers, 18 fathers) and 23 patients were included in this study. Fair agreement was found between Kelly and Krickenbeck protocols (κ = 0.343; p < 0.001), between JSGA constipation and Holschneider protocols (κ = 0.276; p = 0.002); JSGA constipation and Krickenbeck protocols (κ = 0.256; p = 0.004); and between Holschneider and Krickenbeck protocols (κ = 0.273; p = 0.003). Only the Kelly protocol showed significant correlation between parents and patients' answers (ρ = 0.459, p = 0.028). Krickenbeck demonstrated the best negative correlation of patients' scores with ARM types (ρ = -0.401, p = 0.001). The Kelly protocol ranked highest when comparing ease of understanding.
Conclusion: All the questionnaires appeared comparable in assessing postoperative faecal continence in ARM patients. The Kelly questionnaire performed best in 3 key areas of assessment.
Level of Evidence: Level III Cross-Sectional Study.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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