Krickenbeck Evaluation for Functional Outcomes in Children with Anorectal Malformation

Introduction: Anorectal malformation (ARM) is one of the most common congenital disorders that is treated by pediatric surgeons. Many methods of definitive surgery were introduced to achieve good functional outcomes. Several prognostic factors have been reported to influence the bowel functional outcomes of children with ARM after operation. Krikenbeck scoring system is the most common scoring in assessing functional outcomes of children with ARM. Here, we investigated the prognostic variables for bowel functional outcomes in children with ARM after operation using the Krickenbeck score. Methods: A cross-sectional design was performed using medical records of children with ARM who underwent operation from 2012 until 2016. The prognostic factors included age at definitive surgery, type of surgery, presence of wound dehiscence, and dilation. Results: There were 72 ARM patients involved in this study: 38 males and 34 females. Most (60) patients achieved voluntary bowel movement (VBM), but only 5.6 and 9.7 of subjects suffered from soiling and constipation after definitive surgery. Patients who underwent dilation showed an 11-fold higher possibility of achieving VBM than patients without dilation. Interestingly, the relationship almost reached a significant association (p=0.057). None of the prognostic factors affected the constipation and soiling rate in children with ARM after operation (p>0.05). Conclusion: Most ARM patients reveal relatively good functional outcomes after definitive surgery. Our study shows that dilation might benefit the VBM of ARM patients following definitive surgery. It is necessary to conduct a more extensive multicenter study to confirm our results. © 2024 Universiti Putra Malaysia Press. All rights reserved.