Long term follow-up and transition of care in anorectal malformations: An international survey

J Pediatr Surg. 2016 Sep;51(9):1450-7. doi: 10.1016/j.jpedsurg.2016.03.011. Epub 2016 Apr 6.

Abstract

Background: The aim of the study was to assess current international practice in the long term follow-up, in managing active problems and transition of care for teenagers born with anorectal malformations (ARM).

Methods: An original survey was administered to delegates attending two large colorectal surgical meetings in 2015. The 21 questions covered long term follow-up, specific issues for teenagers and transition of care.

Results: 96/236 delegates completed the survey. Follow-up was routinely suspended before 10 year of age by 33% of respondents. 90% of them did not use a scoring system to assess or risks stratify patients, despite 81% stating that an objective score would be beneficial. 40% of respondents felt that >30% of their teenagers had ongoing active medical or psychosocial issues. 42% thought their patients were not ready to be transitioned. The process of transition should start around 13-16 years according to 54% of respondents. 72% had no protocol for transition and 82% did not hold multidisciplinary meetings with adult practitioners before transition.

Conclusions: International consensus on the following aspects of the care in ARM is needed: structured long term follow-up, objective assessment and risk stratification scores, pathways of transition and methods to prepare patients, parents and adult practitioners.

Keywords: Anorectal malformation; Children; Follow-up; Long term outcomes; Teenagers; Transition of care.

MeSH terms

  • Adolescent
  • Aftercare / methods*
  • Aftercare / statistics & numerical data
  • Anorectal Malformations / complications
  • Anorectal Malformations / psychology
  • Anorectal Malformations / therapy*
  • Child
  • Child, Preschool
  • Consensus
  • Global Health
  • Health Care Surveys
  • Humans
  • Infant
  • Infant, Newborn
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Transition to Adult Care* / statistics & numerical data