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The impact of perioperative care on complications and short term outcome in ARM type rectovestibular fistula: An ARM-Net consortium study
- Source :
- Journal of Pediatric Surgery, 54(8), 1595-1600. W B SAUNDERS CO-ELSEVIER INC, Journal of Pediatric Surgery, 54, 1595-1600, Journal of Pediatric Surgery, 54, 8, pp. 1595-1600, van der Steeg, H J J, van Rooij, I A L M, Iacobelli, B D, Sloots, C E J, Leva, E, Broens, P, Fascetti Leon, F, Makedonsky, I, Schmiedeke, E, García Vázquez, A, Midrio, P, Lisi, G, Amerstorfer, E, Miserez, M, Fanjul, M, Ludwiczek, J, Stenström, P, Giuliani, S, van der Steeg, A F W, de Blaauw, I & ARM-Net consortium 2019, ' The impact of perioperative care on complications and short term outcome in ARM type rectovestibular fistula: An ARM-Net consortium study ', Journal of Pediatric Surgery, vol. 54, no. 8, pp. 1595-1600 . https://doi.org/10.1016/j.jpedsurg.2019.03.008, Journal of Pediatric Surgery, 54(8), 1595-1600. W.B. Saunders Ltd, Journal of Pediatric Surgery, 54(8), 1595-1600. W.B. Saunders
- Publication Year :
- 2019
- Publisher :
- W.B. Saunders, 2019.
-
Abstract
- Background: The impact of perioperative care interventions on postreconstructive complications and short-term colorectal outcome in patients with anorectal malformation (ARM) type rectovestibular fistula is unknown.Methods: An ARM-Net consortium multicenter retrospective cohort study was performed including 165 patients with a rectovestibular fistula. Patient characteristics, perioperative care interventions, timing of reconstruction, postreconstructive complications and the colorectal outcome at one year of follow-up were registered.Results: Overall complications were seen in 26.8% of the patients, of which 41% were regarded major. Differences in presence of enterostomy, timing of reconstruction, mechanical bowel preparation, antibiotic prophylaxis and postoperative feeding regimen had no impact on the occurrence of overall complications. However, mechanical bowel preparation, antibiotic prophylaxis >= 48 h and postoperative nil by mouth showed a significant reduction in major complications. The lowest rate of major complications was found in the group having these three interventions combined (5.9%).Multivariate analyses did not show independent significant results of any of the perioperative care interventions owing to center-specific combinations. At one year follow-up, half of the patients experienced constipation and this was significantly higher among those with preoperative mechanical bowel preparation.Conclusions: Differences in perioperative care interventions do not seem to impact the incidence of overall complications in a large cohort of European rectovestibular fistula-patients. Mechanical bowel preparation, antibiotic prophylaxis >= 48 h, and postoperative nil by mouth showed the least major complications. Independency could not be established owing to center-specific combinations of interventions.Type of study: Treatment study. (C) 2019 Elsevier Inc. All rights reserved.
- Subjects :
- medicine.medical_specialty
Constipation
Multivariate analysis
Complications
ANORECTAL-MALFORMATIONS
Psychological intervention
CHILDREN
ANTERIOR SAGITTAL ANORECTOPLASTY
Pediatrics
Perioperative Care
03 medical and health sciences
Anorectal malformation (ARM)
Antibiotic prophylaxis
Mechanical bowel preparation
Perioperative care
Postoperative feeding regimen
Surgery
Pediatrics, Perinatology and Child Health
0302 clinical medicine
All institutes and research themes of the Radboud University Medical Center
Postoperative Complications
030225 pediatrics
medicine
SURGICAL SITE INFECTION
Humans
Rectal Fistula
Retrospective Studies
MECHANICAL BOWEL PREPARATION
business.industry
Incidence (epidemiology)
PARENTERAL-NUTRITION
Retrospective cohort study
General Medicine
Evidence-based medicine
Perinatology and Child Health
Antibiotic Prophylaxis
VESTIBULAR FISTULA
PREVENTION
Anorectal Malformations
Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10]
Parenteral nutrition
Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10]
ELECTIVE COLORECTAL SURGERY
030220 oncology & carcinogenesis
PEDIATRIC SURGEONS
medicine.symptom
business
Subjects
Details
- ISSN :
- 15315037 and 00223468
- Volume :
- 54
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Surgery
- Accession number :
- edsair.doi.dedup.....8495a59c362beb4d77c4ba7439c222af