Journal article
Functional Outcomes for Patients With Congenital Anorectal Malformations: A Systematic Review and Evidence-based Guideline From the APSA Outcomes and Evidence Based Practice Committee
Journal of pediatric surgery, v 60(5), 162243
01 May 2025
PMID: 40023107
Abstract
Consensus on functional outcomes for anorectal malformations (ARM) is hindered by the heterogeneity of the available literature. Optimal patient counseling includes discussion of short- and long-term outcomes for bowel and urinary continence, sexual and psychosocial function, transitional care, and quality of life. This systematic review examines and summarizes the current literature available related to functional outcomes for children with ARM.
The American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee drafted consensus-based questions regarding anorectal malformations. Pertinent articles from 1985 to 2021 were reviewed.
More than 10,843 publications were reviewed with 109 being included in the final recommendations. Recommendations are primarily based on C-D levels of evidence. Continence and constipation rates were higher in patients with perineal fistula and rectovestibular fistula, although symptoms tended to improve as patients got older. Urological anomalies are common and longer term urologic surveillance protocols for patients with ARM need to be further outlined. Sexual and psychosocial issues are common, but ARM patients can have a good quality of life when gastrointestinal symptoms are minimized. Many of the problems associated with ARM can persist into adulthood, supporting structured care plans as patients transition to adult care.
Evidence to support best practices and achieve optimal outcomes for patients with ARM is lacking for many aspects of care. Multi-institutional registries have begun to address management and prognosis for these patients. Prospective and comparative studies are needed to improve care and provide consensus guidelines for this complex patient population.
4.
Metrics
1 Record Views
Details
- Title
- Functional Outcomes for Patients With Congenital Anorectal Malformations: A Systematic Review and Evidence-based Guideline From the APSA Outcomes and Evidence Based Practice Committee
- Creators
- Kristy L. Rialon - Texas Children's HospitalCaitlin Smith - University of WashingtonRebecca M. Rentea - Children's Mercy HospitalShannon N. Acker - University of Colorado DenverRobert Baird - BC Children's HospitalAlana L. Beres - St. Christopher's Hospital for ChildrenHenry L. Chang - Johns Hopkins All Children's HospitalEmily R. Christison-Lagay - Yale New Haven HospitalDiana L. Diesen - The University of Texas Southwestern Medical CenterBrian R. Englum - University of Maryland, BaltimoreKatherine W. Gonzalez - St. Luke's Children's HospitalBrian C. Gulack - Rush University Medical CenterP. Benson Ham - Women & Children's Hospital of BuffaloCarlos T. Huerta - University of MiamiAfif N. Kulaylat - Penn State Milton S. Hershey Medical CenterTamar L. Levene - Joe DiMaggio Children's HospitalDonald J. Lucas - Uniformed Services University of the Health SciencesSara A. Mansfield - Nationwide Children's HospitalChristopher Pennell - Mercy HospitalRobert L. Ricca - Prisma HealthJason P. Sulkowski - Children's Hospital of Richmond at VCUJun Tashiro - NYU Langone HealthDerek Wakeman - University of RochesterYasmine Yousef - Joe DiMaggio Children's HospitalLorraine I. Kelley-Quon - Children's Hospital of Los AngelesAkemi Kawaguchi - University of HoustonAmerican Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee
- Publication Details
- Journal of pediatric surgery, v 60(5), 162243
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics; Surgery
- Web of Science ID
- WOS:001439098300001
- Scopus ID
- 2-s2.0-85218914366
- Other Identifier
- 991022197400204721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
Source: SDGs in the Output
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Pediatrics
- Surgery