Preliminary report on the International Conference for the Development of Standards for the Treatment of Anorectal Malformations

J Pediatr Surg. 2005 Oct;40(10):1521-6. doi: 10.1016/j.jpedsurg.2005.08.002.


Background: Anorectal malformations (ARM) are common congenital anomalies seen throughout the world. Comparison of outcome data has been hindered because of confusion related to classification and assessment systems.

Methods: The goals of the Krinkenbeck Conference on ARM was to develop standards for an International Classification of ARM based on a modification of fistula type and adding rare and regional variants, and design a system for comparable follow up studies.

Results: Lesions were classified into major clinical groups based on the fistula location (perineal, recto-urethral, recto-vesical, vestibular), cloacal lesions, those with no fistula and anal stenosis. Rare and regional variants included pouch colon, rectal atresia or stenosis, rectovaginal fistula, H-fistula and others. Groups would be analyzed according to the type of procedure performed stratified for confounding associated conditions such as sacral anomalies and tethered cord. A standard method for postoperative assessment of continence was determined.

Conclusions: A new International diagnostic classification system, operative groupings and a method of postoperative assessment of continence was developed by consensus of a large contingent of participants experienced in the management of patients with ARM. These methods should allow for a common standardization of diagnosis and comparing postoperative results.

Publication types

  • Congress

MeSH terms

  • Anal Canal / abnormalities*
  • Anal Canal / surgery*
  • Child
  • Digestive System Surgical Procedures / standards
  • Humans
  • Rectum / abnormalities*
  • Rectum / surgery*