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Tethered cord in patients affected by anorectal malformations: a survey from the ARM-Net Consortium.

Abstract：

PURPOSE:The goal of this study was to determine the degree of consensus in the management of spinal cord tethering (TC) in patients with anorectal malformation (ARM) in a large cohort of European pediatric centers. METHODS:A survey was sent to pediatric surgeons (one per center) members of the ARM-Net Consortium. RESULTS:Twenty-four (86%) from ten different countries completed the survey. Overall prevalence of TC was: 21% unknown, 46% below 15, and 29% between 15 and 30%. Ninety-six agreed on screening all patients for TC regardless the type of ARM and 79% start screening at birth. Responses varied in TC definition and diagnostic tools. Fifty percent of respondents prefer ultrasound (US), 21% indicate either US or magnetic resonance (MRI) based on a pre-defined risk of presenting TC, and 21% perform both. Discrepancy exists in complementary test: 82% carry out urodynamic studies (UDS) and only 37% perform somatosensory-evoked potentials (SSEP). Prophylactic untethering is performed in only two centers (8%). CONCLUSIONS:Survey results support TC screening in all patients with ARM and conservative management of TC. There is discrepancy in the definition of TC, screening tools, and complementary test. Protocols should be developed to avoid such variability in management.

journal_name

Pediatr Surg Int

journal_title

Pediatric surgery international

authors

Fanjul M,Samuk I,Bagolan P,Leva E,Sloots C,Giné C,Aminoff D,Midrio P,ARM-Net Consortium.

doi

10.1007/s00383-017-4105-4

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

849-854

issue

8

eissn

0179-0358

issn

1437-9813

pii

10.1007/s00383-017-4105-4

journal_volume

33

pub_type

杂志文章,多中心研究

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