V Shankar Raman1,2, Sandeep Agarwala3, Veereshwar Bhatnagar3. 1. Department of Pediatric Surgery, All Indian Institute of Medical Sciences, New Delhi, India. shankyafmc@yahoo.com. 2. Department of Pediatric Surgery, Army hospital R&R, New Delhi, 110010, India. shankyafmc@yahoo.com. 3. Department of Pediatric Surgery, All Indian Institute of Medical Sciences, New Delhi, India.
Abstract
OBJECTIVE: To correlate the functional outcomes in children operated for anorectal malformations (ARM) using the Krickenbeck consensus and their quality of life (QOL). METHODS: Thirty-three children operated at a tertiary care Pediatric surgery centre were studied 2 y after completion of all the surgeries and if more than 3 y of age. The functional stooling outcomes, type of anomalies and surgical procedures were tabulated using the Krickenbeck classification. The QOL questionnaire consisted of five parameters (Social habit, school attendance, daily activity, relation to peers and feeling) and the scoring ranged between 0 and 12: Good (8-12), Fair (5-7) and Poor (0-4). RESULTS: Median age of the children at the time of study was 7 y (Range 4-14). Comparison of stooling outcomes and QOL showed no significant difference (p 0.48). QOL was not affected by the age at evaluation, type of anomaly and type of surgical procedure. Children with vertebral, anorectal, cardiac, tracheoesophageal, radial and limb abnormalities (VACTERL) association had poorer QOL as compared to children without VACTERL association (p 0.02). Poor stooling outcomes were seen in children who underwent abdominoperineal pull through procedure (p 0.02). CONCLUSION: QOL appears to be independent of the stooling outcomes in operated children of ARM with majority enjoying a good QOL (93.9%).
OBJECTIVE: To correlate the functional outcomes in children operated for anorectal malformations (ARM) using the Krickenbeck consensus and their quality of life (QOL). METHODS: Thirty-three children operated at a tertiary care Pediatric surgery centre were studied 2 y after completion of all the surgeries and if more than 3 y of age. The functional stooling outcomes, type of anomalies and surgical procedures were tabulated using the Krickenbeck classification. The QOL questionnaire consisted of five parameters (Social habit, school attendance, daily activity, relation to peers and feeling) and the scoring ranged between 0 and 12: Good (8-12), Fair (5-7) and Poor (0-4). RESULTS: Median age of the children at the time of study was 7 y (Range 4-14). Comparison of stooling outcomes and QOL showed no significant difference (p 0.48). QOL was not affected by the age at evaluation, type of anomaly and type of surgical procedure. Children with vertebral, anorectal, cardiac, tracheoesophageal, radial and limb abnormalities (VACTERL) association had poorer QOL as compared to children without VACTERL association (p 0.02). Poor stooling outcomes were seen in children who underwent abdominoperineal pull through procedure (p 0.02). CONCLUSION: QOL appears to be independent of the stooling outcomes in operated children of ARM with majority enjoying a good QOL (93.9%).
Entities:
Keywords:
Adverse stooling outcomes; Anorectal malformations; Krickenbeck classification; Quality of life; VACTERL association
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