The Importance of Screening for Additional Anomalies in Patients with Anorectal Malformations: A Retrospective Cohort Study

被引:15
作者
de Beaufort, Cunera M. C. [1 ,2 ,3 ]
van den Akker, Alex C. M. [1 ]
Kuijper, Caroline F. [4 ]
Broers, Chantal J. M. [5 ]
de Jong, Justin R. [1 ,2 ,3 ]
de Beer, Sjoerd A. [1 ]
Straver, Bart [6 ]
Zwijnenburg, Petra J. G. [7 ]
Gorter, Ramon R. [1 ,2 ,3 ]
机构
[1] Univ Amsterdam, Amsterdam UMC, Emma Childrens Hosp, Dept Pediat Surg, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands
[2] Amsterdam Gastroenterol Endocrinol Metab Res Inst, Amsterdam, Netherlands
[3] Amsterdam Reprod & Dev Res Inst, Amsterdam, Netherlands
[4] Univ Amsterdam, Amsterdam UMC, Emma Childrens Hosp, Dept Pediat Urol, Meibergdreef 9, Amsterdam, Netherlands
[5] Univ Amsterdam, Amsterdam UMC, Emma Childrens Hosp, Dept Pediat, Meibergdreef 9, Amsterdam, Netherlands
[6] Univ Amsterdam, Amsterdam UMC, Emma Childrens Hosp, Dept Pediat Cardiol, Meibergdreef 9, Amsterdam, Netherlands
[7] Univ Amsterdam, Amsterdam UMC, Emma Childrens Hosp, Dept Pediat, Meibergdreef 9, Amsterdam, Netherlands
关键词
Anorectal malformation; VACTERL-Association; Genetics; Additional anomalies; Screening; ESOPHAGEAL ATRESIA; VATER ASSOCIATION; CHILDREN; FISTULA;
D O I
10.1016/j.jpedsurg.2022.11.010
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background: In children with anorectal malformations (ARM), additional anomalies can occur within the VACTERL-association. Routine screening is of great importance for early identification and potential treatment. However, uniformity in screening protocols is lacking and only small cohorts have been described in literature. The aim of this study was to assess and describe a unique large cohort of ARM patients who underwent VACTERL screening in the neonatal period. Methods: A retrospective mono-center cohort study was performed. Included were all neonates born between January 2000 and December 2020 who were diagnosed with ARM and screened for additional anomalies. Full screening consisted of x-ray and ultrasound of the spine, cardiac and renal ultrasound, and physical examination for limb deformities, esophageal atresia, and ARM. Criteria for VACTERLclassification were predefined according to the EUROCAT-definitions. Results: In total, 216 patients were included, of whom 167 (77.3%) underwent full VACTERL-screening (66% in 2000-2006 vs. 82% in 2007-2013 vs. 86% in 2014-2020). Median age at follow-up was 7.0 years (IQR 3.0-12.8). In 103/167 patients (61.7%), additional anomalies were identified. Some 35/216 patients (16.2%) fulfilled the criteria of a form of VACTERL-association. In 37/216 patients (17.1%), a genetic cause or syndrome was found. Conclusions: The majority of ARM patients underwent full screening to detect additional anomalies (77%), which improved over time to 86%. Yet, approximately a quarter of patients was not screened, with the potential of missing important additional anomalies that might have severe consequences in the future. Forms of VACTERL-association or genetic causes were found in 16% and 17% respectively. This study emphasizes the importance of routine screening. Level of evidence: III. & COPY; 2022 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
引用
收藏
页码:1699 / 1707
页数:9
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