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Multicenter Study of 342 Anorectal Malformation Patients: Age, Gender, Krickenbeck Subtypes, and Associated Anomalies Publisher Pubmed



Banu T1, 2, 10 ; Karim A2, 3 ; Adel MG1, 4 ; Lakhoo K1, 5 ; Aziz TT2 ; Das A2 ; Sharmeen N2 ; Yapo B1, 6 ; Ferdous KMNU2, 7 ; Kabir KA2, 7 ; Zahid MK1, 2, 8 ; Ford K1, 5 ; Ahsan MQ2, 9 ; Akter M2 Show All Authors
Authors
  1. Banu T1, 2, 10
  2. Karim A2, 3
  3. Adel MG1, 4
  4. Lakhoo K1, 5
  5. Aziz TT2
  6. Das A2
  7. Sharmeen N2
  8. Yapo B1, 6
  9. Ferdous KMNU2, 7
  10. Kabir KA2, 7
  11. Zahid MK1, 2, 8
  12. Ford K1, 5
  13. Ahsan MQ2, 9
  14. Akter M2
  15. Alam MA2
  16. Hoque M2, 9
Show Affiliations
Authors Affiliations
  1. 1. Global Initiative for Children's Surgery (GICS), United Kingdom
  2. 2. Chittagong Research Institute for Children Surgery, Chittagong, Bangladesh
  3. 3. Department of Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
  4. 4. Department of Pediatric Surgery, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Oxford Children's Hospital and University of Oxford, Oxford, United Kingdom
  6. 6. National Department of Health, Mt Hagen Highlands Regional Hospital, Mount Hagen, Papua New Guinea
  7. 7. Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh
  8. 8. Shaheed Suhrawardy Medical College and Hospital, Dhaka, Bangladesh
  9. 9. Department of Pediatric Surgery, Chattogram Ma O Shishu Hospital, Bangladesh
  10. 10. Chittagong Research Institute for Children Surgery, 29 Panchlaish, Chittagong, 4203, Bangladesh

Source: European Journal of Pediatric Surgery Published:2020


Abstract

Introduction Published studies based on Krickenbeck classification of anorectal malformations (ARMs) are still insufficient to assess the global as well as regional relative incidence of different ARM subtypes, gender distribution, and associated anomalies. The primary purpose of this study was to provide an estimate of those in Global Initiative for Children's Surgery (GICS) research group. Materials and Methods We collected ARM data prospectively for 1 year from four institutes of different geographic locations. A total of 342 patients were included in this study (195, 126, 11, and 10 from Bangladesh, Iran, Papua New Guinea, and Oxford, United Kingdom, respectively). Results Overall male to female ratio was 1:1. The most frequent ARM subtype was perineal fistula (23.7% = 81/342). About 48.5% (166/342) patients had at least one associated anomaly. Cardiac and genitourinary systems were the most commonly affected systems, 31.6% (108/342) and 18.4% (63/342), respectively. These organ-systems were followed by anomalies of vertebral/spinal (9.9% = 34/342), musculoskeletal (4.4% = 15/342), and gastrointestinal/abdominal (3.2% = 11/342) systems. Rectovesical fistula had the highest percentage (96.4% = 27/28) of associated anomalies. About 18.1% (62/342) patients had multiple anomalies. ARMs (both isolated and with associated anomalies) occurred equally in males and females. Comparison between patients from Bangladesh and Iran showed differences in relative incidence in ARM subtypes. In addition, Iranian patient group had higher percentage of associated anomalies compared with Bangladeshi (73 vs. 35.4%). Conclusion Our study provides important insights about ARM subtypes, gender distribution and associated anomalies based on Krickenbeck classification especially from Bangladesh and Iran. © 2020 Georg Thieme Verlag. All rights reserved.