EN
TÜRKÇE
Poster - 323
Evaluation of Functional Outcomes and Quality of Life Following Constipation Treatment in Patients with Anorectal Malformations
Şükrüye Demirkaya 1, Elif Emel Erten 2, Fatih Turgul 1, Can İhsan Öztorun 2, Müjdem Nur Azılı 2, Emrah Şenel 2
1 Ankara Bilkent City Hospital Department of Pediatric Surgery
2 Ankara Yildirim Beyazit University Medical Faculty, Department of Pediatric Surgery
Aim
In patients with anorectal malformations (ARMs), the treatment goal is achieving continence, supporting psychosocial development and improving quality of life. We aimed to evaluate the effect of constipation management on fecal continence and quality of life in children operated for ARM between 2007 and 2017.
Methods
This prospective observational study included patients previously operated for ARM. Before initiating constipation treatment and 4–8 weeks after the intervention, patients were assessed using the Krickenbeck functional classification and the Pediatric Quality of Life Inventory (PedsQL). The PedsQL was completed separately by both the child and the caregiver. Changes in functional and quality-of-life scores were analyzed using the Wilcoxon signed-rank test.
Results
A total of 50 patients aged 8–18 years (mean: 11.7) were included in the study. Of the participants 52% were male and 48% female. Based on clinical need, patients received dietary recommendations (71%), laxatives (12%), rectal enemas (12%), or surgical revision (4%) over a 4–8 week period. Post-treatment Krickenbeck scores showed significant improvement in soiling (36%, p=0.0017) and constipation (36%, p=0.0002). Overall improvement in Krickenbeck scores was observed in 44% of patients (p=0.0002). In the child-reported PedsQL assessments, only the physical health domain showed a significant increase (26%, p=0.0013). In contrast, caregiver reports demonstrated significant improvements in physical (30%, p=0.0006), emotional (22%, p=0.0273), social (12%, p=0.0336), and school functioning (10%, p=0.0412) domains.
Conclusions
Short-term medical management for constipation leads to meaningful improvement in functional outcomes, particularly in soiling and constipation domains. While children mainly reported improvement in physical aspects, parents observed broader enhancements in their children's quality of life. These findings emphasize the importance of treating constipation even in late postoperative follow-up and considering both patient and caregiver perspectives in evaluating outcomes.