A comparison of clinical protocols for assessing postoperative fecal continence in anorectal malformation

作者：Ochi Takanori; Okazaki Tadaharu; Miyano Go; Lane Geoffrey J; Yamataka Atsuyuki^*

来源：Pediatric Surgery International, 2012, 28(1): 1-4.

DOI：10.1007/s00383-011-2997-y

• Anorectal malformation
• Clinical assessment
• Fecal continence

Background We compared four protocols for assessing fecal continence (FC) in anorectal malformation (ARM). %26lt;br%26gt;Methods Of 111 ARM cases we treated by anoplasty from 1995 to 2007, 59 have been followed up for more than 4 years [male high (n = 23), male low (n = 12), female high (n = 7), and female low (n = 17)] and 27 for more than 7 years [male high (n = 11), male low (n = 5), female high (n = 5), and female low (n = 6)]. FC was assessed in these 86 cases using each of the four protocols; the Kelly score (0-6 points), the Japanese Study Group of Anorectal Anomalies (JSGA) score (0-8 points), the Holschneider score (0-14 points), and our original score (0-10 points). %26lt;br%26gt;Results were re-classified into four outcome levels (good, fair, poor, very poor) for direct comparison. Results Outcome was different by two levels (i.e., good vs. very poor) in 7 (8.1%) assessments and different by one category (i.e., fair vs. poor) in ten assessments (11.6%). Outcome was different most often in male high ARM cases and JSGA scores were most divergent. %26lt;br%26gt;Conclusions Fecal continence in male high ARM appears to be assessed inconsistently and a review of protocols may be of value to standardize clinical assessment and enhance reliability.

• 出版日期2012-1