Author/Editor		Gvardijančič, Diana; Tomažič, Aleš
Title		Kontinenca pri otrocih rojenih z anorektalnimi anomalijami
Translated title		Continence in children born with anorectal malformations
Type		članek
Source		In: Repše S, Tršinar B, editors. Zbornik predavanj 39. podiplomskega tečaja kirurgije; 2003 okt 17-18; Ljubljana. Ljubljana: Kirurška klinika, Klinični center,
Publication year		2003
Volume		str. 46-50
Language		slo
Abstract		Background. Fecal incontinences a serious problem that provokes social segregation and psychologic sequele. In general, treatment plans for fecal incontinence should not be viewed as »cures« but rather an approach toward a more normal Iifestyle.The sphincter mechanism, peristalsis and the consistency of the stool all influence the ability to control the voiding of the fecal mass. Children with anorectal malformations have a heterogenous quantity of shincteric muscles, sensory nerves and proprioceptive fibers and abnormal rectosigmoid motility. After the repair we find that children often have problems with soiling orconstipation. Bowel management helps to aleviate the problems by influencing the lifestyle, prescribing a diet, laxatives or enemas. Methods and patients. Until 1997 we operated anorectal malformations using the YV plasty or transposition of the anus for the lower and some intermediate anomalies and the pull-through method described by Stephens for higher anomalies. Since 1997 we operate all anomalies using the posterior sagittal approach. From 31.1.1993 until 31. 1. 2003 we have operated 54 children.10 underwent the YV plasty or transposition of the anus, in 4 we performed the pull through and in 40 we used the posterior sagittal approach (17 a small operation and 23 a posterior sagittal anorectoplasty (PSARP)). Results. All 10 children after the YV plasty or transposition of the anus are clean, one occasionally needs an enema. 3 children after the pullthrough all need regular enemas to stay clean, one was lost to follow up. After a minimal PSARP all 17 children are clean. Of the 3 children with a malformation without a fistula 2 are clean and 1 needs regular enemas. (Abstract truncated at 2000 characters)
Descriptors		FECAL INCONTINENCE ANUS RECTUM CHILD