European Reference Network eUROGEN guidelines on the management of anorectal malformations, part II: treatment

Introduction Anorectal malformations (ARMs) are rare birth defects affecting the anorectum and oftentimes the genitourinary region. The management of ARM patients is complex and requires highly specialized surgical and medical care. The European Reference Network eUROGEN for rare and complex urogeni...

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Main Authors: Aubert, Ophelia (Author) , Irvine, Willemijn F. E. (Author) , Aminoff, Dalia (Author) , Baauw, Ivo de (Author) , Cascio, Salvatore (Author) , Cretolle, Célia (Author) , Iacobelli, Barbara Daniela (Author) , Mantzios, Konstantinos (Author) , Midrio, Paola (Author) , Miserez, Marc (Author) , Sarnacki, Sabine (Author) , Schmiedeke, Eberhard (Author) , Schwarzer, Nicole (Author) , Sloots, Cornelius (Author) , Stenström, Pernilla (Author) , Lacher, Martin (Author) , Gosemann, Jan-Hendrik (Author)
Format: Article (Journal)
Language:English
Published: 2024
In: European journal of pediatric surgery

ISSN:1439-359X
DOI:10.1055/s-0044-1791257
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1055/s-0044-1791257
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Author Notes:Ophelia Aubert, Willemijn F.E. Irvine, Dalia Aminoff, Ivo de Blaauw, Salvatore Cascio, Célia Cretolle, Barbara Daniela Iacobelli, Konstantinos Mantzios, Paola Midrio, Marc Miserez, Sabine Sarnacki, Eberhard Schmiedeke, Nicole Schwarzer, Cornelius Sloots, Pernilla Stenström, Martin Lacher, Jan-Hendrik Gosemann

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520 |a Introduction Anorectal malformations (ARMs) are rare birth defects affecting the anorectum and oftentimes the genitourinary region. The management of ARM patients is complex and requires highly specialized surgical and medical care. The European Reference Network eUROGEN for rare and complex urogenital conditions aimed to develop comprehensive guidelines for the management of ARM applicable on a European level. Methods The Dutch Quality Standard for ARM served as the basis for the development of guidelines. Literature was searched in Medline, Embase, and Cochrane. The ADAPTE method was utilized to incorporate the newest available evidence. A panel of 15 experts from seven European countries assessed currency, acceptability, and applicability of recommendations. Recommendations from the Dutch Quality Standard were adapted, adopted, or rejected and recommendations were formed considering the current evidence, expert opinion, and the European context. Results Surgical and medical treatment of ARM, postoperative instructions, toilet training, and management of fecal and urinary incontinence were addressed. Seven new studies were identified. The panel adapted 23 recommendations, adopted 3, and developed 8 de novo. The overall level of newly found evidence was considered low. Conclusion Treatment of ARM patients requires a multidisciplinary team and expertise about anatomical and surgical aspects of the disease, as well as long-term follow-up. This guideline offers recommendations for surgical and medical treatment of ARM and associated complications, according to the best available evidence and applicable on a European level. 
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