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Screening practices and associated anomalies in infants with anorectal malformations: Results from the Midwest Pediatric Surgery Consortium
Authors
Amin Afrazi
Casey M. Calkins
+25 more
Jennifer N. Cooper
Katherine J. Deans
Cynthia D. Downard
Peter Ehrlich
Jason Fraser
Samir K. Gadepalli
Devin R. Halleran
Michael A. Helmrath
Rashmi S. Kabre
Jonathan E. Kohler
Rachel Landisch
Matthew P. Landman
Constance Lee
Marc A. Levitt
Charles M. Leys
Daniel L. Lodwick
Grace Z. Mak
Beth McClure
Peter C. Minneci
Rodrigo Mon
Beth Rymeski
Jacqueline M. Saito
Thomas T. Sato
Shawn D. St. Peter
Richard Wood
Publication date
1 June 2018
Publisher
Health Sciences Research Commons
Abstract
© 2018 Elsevier Inc. 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\u27s 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 \u3c 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: II
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Last time updated on 03/12/2020