Abstract
Background
Anorectal malformations (ARM) are common congenital anomalies seen throughout the
world. Comparison of outcome data has been hindered because of confusion related to
classification and asssessment systems.
Methods
The goals of the Krinkenbeck Conference on ARM was to develop standards for an International
Classification of ARM based on a modification of fistula type and adding rare and
regional variants, and design a system for comparable follow up studies.
Results
Lesions were classified into major clinical groups based on the fistula location (perineal,
recto-urethral, recto-vesical, vestibular), cloacal lesions, those with no fistula
and anal stenosis. Rare and regional variants included pouch colon, rectal atresia
or stenosis, rectovaginal fistula, H-fistula and others. Groups would be analyzed
according to the type of procedure performed stratified for confounding associated
conditions such as sacral anomalies and tethered cord. A standard method for postoperative
assessment of continence was determined.
Conclusions
A new International diagnostic classification system, operative groupings and a method
of postoperative assessment of continence was developed by consensus of a large contingent
of participants experienced in the management of patients with ARM. These methods
should allow for a common standardization of diagnosis and comparing postoperative
results.
Index words
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© 2005 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
