Pediatric surgery international · 2012
A comparison of clinical protocols for assessing postoperative fecal continence in anorectal malformation.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Ochi Takanori, Okazaki Tadaharu, Miyano Go, Lane Geoffrey J, Yamataka Atsuyuki
Аннотация
BACKGROUND: We compared four protocols for assessing fecal continence (FC) in anorectal malformation (ARM).
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). 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.
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.
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). 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.
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.