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Patient's outcome after definitive surgery using krickenbeck continence score in anorectal malformation
T O R Wahid1, M I Herzoni2, I Ibrahim2
1Department of Pediatric Surgery, Arifin Achmad General Hospital, University of Riau, Riau, Indonesia. tubagus7606@lecturer.unri.ac.id.
Insights
This study evaluated functional outcomes in pediatric patients with anorectal malformations (ARM) after surgery. Most patients achieved voluntary bowel movements, with outcomes linked to birth weight and gender.
Area of Science:
- Pediatric Surgery
- Congenital Anomalies
- Neonatal Care
Background:
- Anorectal malformations (ARM) are common congenital anomalies impacting pediatric surgical patients.
- Neonatal care for ARM focuses on optimizing functional outcomes post-definitive surgery.
- The Krickenbeck continence score is a key metric for assessing ARM patient outcomes.
Purpose of the Study:
- To evaluate functional outcomes in pediatric patients with anorectal malformations (ARM) after definitive surgical repair.
- To assess the effectiveness of surgical interventions for ARM at Arifin Achmad General Hospital.
- To identify factors influencing continence outcomes in ARM patients.
Main Methods:
- A cross-sectional retrospective study was conducted.
- Electronic medical records of ARM patients from 2019-2022 were analyzed.
- The Krickenbeck continence score was used to assess functional outcomes.
Main Results:
- Out of 26 ARM patients (12 males, 14 females), 61.5% achieved Voluntary Bowel Movement (VBM).
- Normal birth weight was associated with better VBM outcomes (P <0.001).
- Male patients demonstrated superior VBM compared to females (P = 0.005).
Conclusions:
- Functional outcomes for ARM patients at the hospital are generally positive.
- A majority of children achieve VBM, with low rates of soiling and constipation.
- Birth weight and gender appear to be significant factors influencing VBM in ARM patients.
Introduction:
Anorectal malformations (ARM) are a common type of congenital anomaly seen in pediatric surgery, with an approximate incidence ranging from 1 in 2,000 to 5,000 live births. The main aim of neonatal care in patients with ARM is to ensure that patients achieve optimal functionality after definitive surgery. The Krickenbeck continence score is used to assess the outcomes of ARM patients. So, this study aimed to evaluate patient outcomes after definitive surgery in Arifin Achmad General Hospital.
Materials And Methods:
This was a cross-sectional retrospective study utilizing electronic medical records of patients with ARM who had undergone a definitive surgery procedure at Arifin Achmad General Hospital, Indonesia, from 2019 to 2022.
Results:
In this study, twenty-six patients with ARM were identified, including 12 males and 14 females. Approximately 76.9% of the patients had normal birth weight. The study found that 61.5% of the patients had ARM without fistula, 15.4% had ARM with rectourethral and perineal fistula, 3.8% had ARM with vestibular fistula, and 3.8% had ARM with cloaca. According to the Krickenbeck continence score, 61.5% of the patients achieved Voluntary Bowel Movement (VBM), while 11.5% experienced soiling and 7.7% experienced constipation. It was observed that normal birth weight patients had finer VBM compared to those with low birth weight (P <0.001), and male patients had finer VBM than females (P = 0.005).
Conclusion:
The results of ARM patients for functional outcomes at our hospital are generally positive. More than half of the children exhibit voluntary bowel movements (VBM), and only a little experience soiling and constipation. The number of VBM may be linked to the child's birth weight and gender.
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