TY - JOUR
T1 - Outcome in anorectal malformation type rectovesical fistula: a nationwide cohort study in The Netherlands
AU - van der Steeg, H. J. J.
AU - Botden, S. M. B. I.
AU - Sloots, C. E. J.
AU - van der Steeg, A. F. W.
AU - Broens, P. M. A.
AU - van Heurn, Ernest
AU - Travassos, D. V.
AU - van Rooij, I. A. L. M.
AU - de Blaauw, I.
PY - 2016/8
Y1 - 2016/8
N2 - Purpose: Outcomes of patients with an ARM-type rectovesical fistula are scarcely reported in medical literature. This study evaluates associated congenital anomalies and long-term colorectal and urological outcome in this group of ARM-patients. Methods: A retrospective Dutch cohort study on patients treated between 1983 and 2014 was performed. Associated congenital anomalies were documented, and colorectal and urological outcome recorded at five and ten years of follow-up. Results: Eighteen patients were included, with a mean follow-up of 10.8 years. Associated congenital anomalies were observed in 89% of the patients, 61% considered a VACTERL-association. Total sacral agenesis was present in 17% of our patients. At five and ten years follow-up voluntary bowel movements were described in 80% and 50%, constipation in 80% and 87%, and soiling in 42% and 63% of the patients, respectively. Bowel management was needed in 90% and one patient had a definitive colostomy. PSARP was the surgical reconstructive procedure in 83%. Urological outcome showed 14 patients (81%) to be continent. No kidney transplantations were needed. Conclusion: In our national cohort of ARM-patients type rectovesical fistula that included a significant proportion of patients with major sacral anomalies, the vast majority remained reliant on bowel management to be clean after ten years follow-up, despite "modern" PSARP-repair. Continence for urine is achieved in the majority of patients, and end-stage kidney failure is rare.
AB - Purpose: Outcomes of patients with an ARM-type rectovesical fistula are scarcely reported in medical literature. This study evaluates associated congenital anomalies and long-term colorectal and urological outcome in this group of ARM-patients. Methods: A retrospective Dutch cohort study on patients treated between 1983 and 2014 was performed. Associated congenital anomalies were documented, and colorectal and urological outcome recorded at five and ten years of follow-up. Results: Eighteen patients were included, with a mean follow-up of 10.8 years. Associated congenital anomalies were observed in 89% of the patients, 61% considered a VACTERL-association. Total sacral agenesis was present in 17% of our patients. At five and ten years follow-up voluntary bowel movements were described in 80% and 50%, constipation in 80% and 87%, and soiling in 42% and 63% of the patients, respectively. Bowel management was needed in 90% and one patient had a definitive colostomy. PSARP was the surgical reconstructive procedure in 83%. Urological outcome showed 14 patients (81%) to be continent. No kidney transplantations were needed. Conclusion: In our national cohort of ARM-patients type rectovesical fistula that included a significant proportion of patients with major sacral anomalies, the vast majority remained reliant on bowel management to be clean after ten years follow-up, despite "modern" PSARP-repair. Continence for urine is achieved in the majority of patients, and end-stage kidney failure is rare.
KW - Anorectal malformation (ARM)
KW - Rectovesical fistula
KW - Bladder neck fistula
KW - Colorectal outcome
KW - Urological outcome
KW - Long-term follow-up
U2 - 10.1016/j.jpedsurg.2016.02.002
DO - 10.1016/j.jpedsurg.2016.02.002
M3 - Article
C2 - 26921937
SN - 0022-3468
VL - 51
SP - 1229
EP - 1233
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 8
ER -