A standardized approach for the assessment and treatment of internationally adopted children with a previously repaired anorectal malformation (ARM)

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• 作者：Victoria A. Lane^a ; ^{Vic5lane@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Clare Skerritt^a ; ^{clareskerritt@nhs.net" class="auth_mail" title="E-mail the corresponding author} ; Richard J. Wood^a ; ^{richard.wood@nationwidechildrens.org" class="auth_mail" title="E-mail the corresponding author} ; Carlos Reck^a ; ^{carlos.reck@nationwidechildrens.org" class="auth_mail" title="E-mail the corresponding author} ; Geri D. Hewitt^a ; ^b ; ^{geri.hewitt@nationwidechildrens.org" class="auth_mail" title="E-mail the corresponding author} ; Kate A. McCracken^a ; ^b ; ^{kate.mcccracken@nationwidechildrens.org" class="auth_mail" title="E-mail the corresponding author} ; Venkata R. Jayanthi^a ; ^c ; ^{Rama.jayanthi@nationwdiechildrens.org" class="auth_mail" title="E-mail the corresponding author} ; Daniel DaJusta^a ; ^c ; ^{Daniel.dajusta@nationwidechildrens.org" class="auth_mail" title="E-mail the corresponding author} ; Christina Ching^a ; ^c ; ^{Christina.ching@nationwidechildrens.org" class="auth_mail" title="E-mail the corresponding author} ; Katherine J. Deans^d ; ^{Katherine.deans@nationwdiechildrens.org" class="auth_mail" title="E-mail the corresponding author} ; Peter C. Minneci^d ; ^{peter.minneci@nationwidechildrens.org" class="auth_mail" title="E-mail the corresponding author} ; Marc A. Levitt^a ; ^{marc.levitt@nationwidechildrens.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Adopted ; Anorectal ; Redo ; Reoperative ; Surgery
• 刊名：Journal of Pediatric Surgery
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：51
• 期：11
• 页码：1864-1870
• 全文大小：481 K

文摘

A significant number of internationally adopted children have congenital birth defects. As a specialist center for colorectal diagnoses, we evaluate such children with an anorectal malformation (ARM) and have found that a significant number need a reoperation. Knowledge of the common complications following ARM surgery has led us to develop treatment algorithms for patients with unknown past medical and surgical history, a situation typically encountered in the adopted population.

Methods

The results of investigations, indications, and rate of reoperation were assessed for adopted children with an ARM evaluated between 2014 and 2016.

Results

56 patients (28 males) were identified. 76.8% required reoperative surgery. Mislocation of the anus outside the sphincter complex was seen in 50% of males and 39.3% of females. Anal stricture, rectal prolapse, retained vaginal septum, and a strictured vaginal introitus were also common.

Conclusion

The reoperative surgery rate in the internationally adopted child with an ARM is high. Complete, systematic evaluation of these children is required to identify complications following initial repair. Development of mechanisms to improve the primary surgical care these children receive is needed.