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Middle-term bowel function and quality of life in low-type anorectal malformation

Haiqing Zheng1, Guangjian Liu1, Zijian Liang2

  • 1Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.

Italian Journal of Pediatrics
|August 15, 2019
PubMed

Insights

Children with low-type anorectal malformations (ARMs) can achieve good bowel function and quality of life (QOL). However, some experience anal function issues impacting QOL, often due to iatrogenic causes.

Area of Science:

  • Pediatric surgery
  • Gastroenterology
  • Quality of Life Research

Background:

  • Low-type anorectal malformations (ARMs) are often considered benign but lack extensive data in China.
  • This study addresses the limited understanding of middle-term outcomes for low-type ARM in Chinese children.

Purpose of the Study:

  • To evaluate middle-term bowel function and quality of life (QOL) in children treated for low-type ARM.
  • To identify factors influencing bowel function and QOL in this pediatric population.

Main Methods:

  • A cohort study including children over 3 years old treated for low-type ARM (vestibular fistula [VF] and perineal fistula [PF]) and healthy controls.
  • Bowel function assessed using the Baylor Continence Scale (BCS); Quality of Life (QOL) measured by the Pediatric Quality of Life Inventory (PedsQL 4.0).

Main Results:

  • Children with low-type ARM (VF and PF) showed significantly higher BCS scores compared to controls, indicating poorer bowel control.
  • No significant differences in overall PedsQL 4.0 scores were found between ARM groups and controls.
  • QOL measures, particularly emotional function, were negatively correlated with BCS scores, suggesting impaired bowel function impacts QOL.

Conclusions:

  • Children with low-type ARM can achieve satisfactory bowel control and QOL.
  • Despite being benign, low-type ARM can lead to anal function problems affecting QOL.
  • Iatrogenic factors such as redo operations, anal malposition, and improper constipation management contribute to fecal incontinence.
Abstract

Keywords:
Bowel functionLow-type anorectal malformationsPerineal fistulaQuality of lifeVestibular fistula

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