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Posterior sagittal anorectoplasty results in better bowel function and quality of life in adulthood than pull-through procedures
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Colorectal Surgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Colorectal Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Colorectal Surgery.
Akad Sjukhuset, Dept Pediat Surg, S-75185 Uppsala, Sweden..
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2015 (English)In: Journal of Pediatric Surgery, ISSN 0022-3468, E-ISSN 1531-5037, Vol. 50, no 9, 1556-1559 p.Article in journal (Refereed) Published
Abstract [en]

Background/purpose: The short-term outcome of posterior sagittal anorectoplasty (PSARP) procedure has been reported to be better than after abdominoperineal or abdominosacroperineal (AP) procedures. This study aimed to investigate the long-term functional outcome and quality of life after PSARP in adulthood and compare with the outcome after AP procedures. Methods: Twenty-four patients operated with PSARP at the Department of Pediatric Surgery, Uppsala, Sweden, from 1984 to 1993 were identified. They were compared with 20 patients that underwent AP pull-through procedures from 1974 to 1983. The patients were sent validated bowel function and quality of life (SF-36) questionnaires. Sixteen PSARP (median age 21, five females) patients and fourteen AP patients (seven abdominosacroperineal and seven abdominoperineal pull-throughs, median age 32, seven females) responded and were included in the study. Results: The median Miller incontinence score was 1 (range 0-13) in the PSARP group and 10 (range 3-16) in the pull-through group (P = 0.0042). The use of underwear protection and oral loperamide was significantly less frequent in the PSARP group (P = 0.0096 and 0.0021 respectively). The SF-36 scores of Vitality, Mental health and Mental Cluster Scale were higher in the PSARP group (P = 0.0291, 0.0500, 0.0421 respectively). Conclusions: PSARP results in superior bowel function and better quality of life in adulthood compared with AP procedures for the repair of anorectal malformations.

Place, publisher, year, edition, pages
2015. Vol. 50, no 9, 1556-1559 p.
Keyword [en]
Anorectal malformation, Posterior sagittal anorectoplasty, Functional outcome, Quality of life
National Category
Surgery Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-264663DOI: 10.1016/j.jpedsurg.2015.02.004ISI: 000361499500023PubMedID: 25783389OAI: oai:DiVA.org:uu-264663DiVA: diva2:861402
Available from: 2015-10-16 Created: 2015-10-15 Last updated: 2017-12-01Bibliographically approved

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Danielson, JohanKarlbom, UrbanGraf, Wilhelm

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