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Sacral ratio and fecal continence in children with anorectal malformations

Mauricio Macedo1, José L Martins, Luiz G Freitas Filho

  • 1Departments of Paediatric Surgery, Hospital Infantil Darcy Vargas, São Paulo, Brazil.

BJU International
|October 13, 2004
PubMed

Insights

The sacral ratio (SR) does not predict fecal continence in patients with anorectal malformations (ARM). While sacral agenesis showed a lower SR, it did not correlate with continence levels in ARM patients.

Area of Science:

  • Pediatric Surgery
  • Radiology
  • Gastroenterology

Background:

  • Anorectal malformations (ARM) present complex challenges in pediatric surgery.
  • Assessing fecal continence post-ARM surgery is crucial for long-term outcomes.
  • The sacral ratio (SR) is a radiographic measurement that has been explored for its potential role in predicting functional outcomes.

Purpose of the Study:

  • To evaluate the sacral ratio (SR) in patients diagnosed with anorectal malformations (ARM).
  • To determine if the sacral ratio (SR) has predictive value for achieving fecal continence after surgical correction of ARM.

Main Methods:

  • A cohort of 42 patients (aged 3-14 years) with prior ARM surgery were assessed.
  • Fecal continence was categorized as continent, partially continent, or incontinent by a single observer.
  • Sacral radiographic images were analyzed to calculate the sacral ratio (SR).

Main Results:

  • No significant difference in the sacral ratio (SR) was found among the three continence groups (continent, partially continent, incontinent).
  • Patients with sacral agenesis exhibited a significantly higher incidence of fecal incontinence.
  • All patients with sacral agenesis had a sacral ratio (SR) below the normal range.

Conclusions:

  • The sacral ratio (SR) is not a reliable predictor of fecal continence in patients with anorectal malformations (ARM).
  • While sacral agenesis is associated with a lower SR and higher incontinence rates, the SR itself lacks practical value for predicting continence in the general ARM population.
Abstract

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