Quality of life and defecative function 10 years or longer after posterior sagittal anorectoplasty and laparoscopic-assisted anorectal pull-through for anorectal malformation
| Autor: | P H Y Chung, Kenneth K. Y. Wong, Pkh Tam, Carol Wing Yan Wong |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Posterior sagittal anorectoplasty medicine.medical_specialty Reconstructive surgery Constipation Adolescent Anal Canal Young Adult 03 medical and health sciences 0302 clinical medicine Quality of life Surveys and Questionnaires 030225 pediatrics Pediatric surgery medicine Humans Malone antegrade continence enema Defecation business.industry Rectum General Medicine Plastic Surgery Procedures Anorectal Malformations Surgery Treatment Outcome Pediatrics Perinatology and Child Health Quality of Life Female Laparoscopy 030211 gastroenterology & hepatology medicine.symptom business Mace Follow-Up Studies Forecasting |
| Zdroj: | Pediatric Surgery International. 36:289-293 |
| ISSN: | 1437-9813 0179-0358 |
| DOI: | 10.1007/s00383-019-04606-x |
| Popis: | In our center, patients with anorectal malformation, including males with recto-vesical (RV)/recto-bladder neck (RBN)/recto-prostatic urethral (RU) fistulas, and females with recto-vaginal (RV) fistulas have been treated by posterior sagittal anorectoplasty (PSARP) before 2000, and by laparoscopic-assisted anorectal pull-through (LAARP) thereafter. We would like to compare the quality of life (QOL) and long-term defecative function between these two groups of patients 10 years after reconstructive surgery. Patients who underwent LAARP between 2001 and 2005 were compared with historical controls treated with PSARP between 1996 and 2000. Degrees of continence were graded by the Krickenbeck classification and Kelly’s score. QOL was assessed by Hirschsprung’s disease/Anorectal Malformation Quality of Life (HAQL) questionnaire. Results were compared using Chi-square test and t test. There were 14 LAARP and 7 PSARP patients. All attained voluntary bowel movements. Moderate to severe soiling (Krickenbeck Grade 2 and 3) was found in 3/14 LAARP (21.4%) and 1/7 PSARP (14.3%) patients, p = 1.00. Constipation requiring use of laxatives was present in 3/14 LAARP (28.6%) and 1/7 PSARP (14.3%) patients, p = 0.62. Mean Kelly’s scores were 3.79 ± 0.98 (LAARP) and 4.71 ± 1.25 (PSARP), p = 0.12. No patient required Malone antegrade continence enema (MACE). The QOL scores based on the HAQL questionnaire were comparable between the two groups in all areas except social functioning, in which the LAARP patients attained a significantly lower mean score (26.4 vs 71.7, p = 0.0001). The 10-year outcome between LAARP and PSARP patients in terms of QOL and defecative function is comparable. Impairment in social functioning in these patients is reflected by the self-reported lower level of functioning. |
| Databáze: | OpenAIRE |
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