Faculty Collaboration Database

Screening practices and associated anomalies in infants with anorectal malformations: Results from the Midwest Pediatric Surgery Consortium. J Pediatr Surg 2018 Jun;53(6):1163-1167

Date

04/01/2018

Pubmed ID

29602552

DOI

10.1016/j.jpedsurg.2018.02.079

Scopus ID

2-s2.0-85044592649 (requires institutional sign-in at Scopus site)   25 Citations

Abstract

BACKGROUND: This study evaluates screening practices and the incidence of associated anomalies in infants with anorectal malformations (ARM).

METHODS: We performed a multi-institutional retrospective cohort study of children born between 2007 and 2011 who underwent surgery for ARM at 10 children's hospitals. ARM type was classified based on the location of the distal rectum, and all screening studies were reviewed.

RESULTS: Among 506 patients, the most common ARM subtypes were perineal fistula (40.7%), no fistula (11.5%), and vestibular fistula (10.1%). At least 1 screening test was performed in 96.6% of patients, and 11.3% of patients underwent all. The proportion of patients with ≥1 abnormal finding on any screening test varied by type of ARM (p<0.001). Screening rates varied from 15.2% for limb anomalies to 89.7% for renal anomalies. The most commonly identified anomalies by screening category were: spinal: tethered cord (20.6%); vertebral: sacral dysplasia/hemisacrum (17.8%); cardiac: patent foramen ovale (58.0%); renal: hydronephrosis (22.7%); limb: absent radius (7.9%).

CONCLUSION: Screening practices and the incidence of associated anomalies varied by type of ARM. The rate of identifying at least one associated anomaly was high across all ARM subtypes. Screening for associated anomalies should be considered standard of care for all ARM patients.

TYPE OF STUDY: Multi-institutional retrospective cohort study.

LEVEL OF EVIDENCE: III.

Author List

Minneci PC, Kabre RS, Mak GZ, Halleran DR, Cooper JN, Afrazi A, Calkins CM, Downard CD, Ehrlich P, Fraser J, Gadepalli SK, Helmrath MA, Kohler JE, Landisch R, Landman MP, Lee C, Leys CM, Lodwick DL, Mon R, McClure B, Rymeski B, Saito JM, Sato TT, St Peter SD, Wood R, Levitt MA, Deans KJ, Midwest Pediatric Surgery Consortium

Author

Casey Matthew Calkins MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Abnormalities, Multiple
Anorectal Malformations
Child
Child, Preschool
Female
Humans
Incidence
Infant
Male
Midwestern United States
Practice Patterns, Physicians'
Retrospective Studies