title: Preliminary report on the International Conference for the Development of Standards for the Treatment of Anorectal Malformations.
abstract: 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.
authors.affiliation: Department of Surgery, Kinderkrankenhaus of the City of Cologne, Amsterdamerstr. 59, 50735 Cologne, Germany. holschneidera@kliniken-koeln.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Holschneider
authors.forename: John
authors.initials: J
authors.lastname: Hutson
authors.forename: Albert
authors.initials: A
authors.lastname: Peña
authors.forename: Elhamy
authors.initials: E
authors.lastname: Beket
authors.forename: Subir
authors.initials: S
authors.lastname: Chatterjee
authors.forename: Arnold
authors.initials: A
authors.lastname: Coran
authors.forename: Michael
authors.initials: M
authors.lastname: Davies
authors.forename: Keith
authors.initials: K
authors.lastname: Georgeson
authors.forename: Jay
authors.initials: J
authors.lastname: Grosfeld
authors.forename: Devendra
authors.initials: D
authors.lastname: Gupta
authors.forename: Naomi
authors.initials: N
authors.lastname: Iwai
authors.forename: Dieter
authors.initials: D
authors.lastname: Kluth
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Martucciello
authors.forename: Samuel
authors.initials: S
authors.lastname: Moore
authors.forename: Risto
authors.initials: R
authors.lastname: Rintala
authors.forename: E Durham
authors.initials: ED
authors.lastname: Smith
authors.forename: D V
authors.initials: DV
authors.lastname: Sripathi
authors.forename: Douglas
authors.initials: D
authors.lastname: Stephens
authors.forename: Sudipta
authors.initials: S
authors.lastname: Sen
authors.forename: Benno
authors.initials: B
authors.lastname: Ure
authors.forename: Sabine
authors.initials: S
authors.lastname: Grasshoff
authors.forename: Thomas
authors.initials: T
authors.lastname: Boemers
authors.forename: Feilin
authors.initials: F
authors.lastname: Murphy
authors.forename: Yunus
authors.initials: Y
authors.lastname: Söylet
authors.forename: Martin
authors.initials: M
authors.lastname: Dübbers
authors.forename: Marc
authors.initials: M
authors.lastname: Kunst
mesh_terms: D001003:Anal Canal / Q000002:abnormalities* / Q000601:surgery*; D002648:Child; D013505:Digestive System Surgical Procedures / Q000592:standards; D006801:Humans; D012007:Rectum / Q000002:abnormalities* / Q000601:surgery*