title: European consensus meeting of ARM-Net members concerning diagnosis and early management of newborns with anorectal malformations.
abstract: The ARM-Net (anorectal malformation network) consortium held a consensus meeting in which the classification of ARM and preoperative workup were evaluated with the aim of improving monitoring of treatment and outcome. The Krickenbeck classification of ARM and preoperative workup suggested by Levitt and Peña, used as a template, were discussed, and a collaborative consensus was achieved. The Krickenbeck classification is appropriate in describing ARM for clinical use. The preoperative workup was slightly modified. In males with a visible fistula, no cross-table lateral X-ray is needed and an anoplasty or (mini-) posterior sagittal anorectoplasty can directly be performed. In females with a small vestibular fistula (Hegar size <5 mm), a primary repair or colostomy is recommended; the repair may be delayed if the fistula admits a Hegar size >5 mm, and in the meantime, gentle painless dilatations can be performed. In both male and female perineal fistula and either a low birth weight (<2,000 g) or severe associated congenital anomalies, prolonged preoperative painless dilatations might be indicated to decrease perioperative morbidity caused by general anesthesia. The Krickenbeck classification is appropriate in describing ARM for clinical use. Some minor modifications to the preoperative workup by Levitt and Peña have been introduced in order to refine terminology and establish a comprehensive preoperative workup.
authors.affiliation: Department of Surgery-Pediatric Surgery, Amalia Children's Hospital-Radboudumc, Nijmegen, The Netherlands, herjan.vandersteeg@radboudumc.nl.
authors.forename: H J J
authors.initials: HJ
authors.lastname: van der Steeg
authors.forename: E
authors.initials: E
authors.lastname: Schmiedeke
authors.forename: P
authors.initials: P
authors.lastname: Bagolan
authors.forename: P
authors.initials: P
authors.lastname: Broens
authors.forename: B
authors.initials: B
authors.lastname: Demirogullari
authors.forename: A
authors.initials: A
authors.lastname: Garcia-Vazquez
authors.forename: S
authors.initials: S
authors.lastname: Grasshoff-Derr
authors.forename: M
authors.initials: M
authors.lastname: Lacher
authors.forename: E
authors.initials: E
authors.lastname: Leva
authors.forename: I
authors.initials: I
authors.lastname: Makedonsky
authors.forename: C E J
authors.initials: CE
authors.lastname: Sloots
authors.forename: N
authors.initials: N
authors.lastname: Schwarzer
authors.forename: D
authors.initials: D
authors.lastname: Aminoff
authors.forename: M
authors.initials: M
authors.lastname: Schipper
authors.forename: E
authors.initials: E
authors.lastname: Jenetzky
authors.forename: I A L M
authors.initials: IA
authors.lastname: van Rooij
authors.forename: S
authors.initials: S
authors.lastname: Giuliani
authors.forename: C
authors.initials: C
authors.lastname: Crétolle
authors.forename: S
authors.initials: S
authors.lastname: Holland Cunz
authors.forename: P
authors.initials: P
authors.lastname: Midrio
authors.forename: I
authors.initials: I
authors.lastname: de Blaauw
mesh_terms: D000015:Abnormalities, Multiple / Q000601:surgery; D000071056:Anorectal Malformations; D001006:Anus, Imperforate / Q000145:classification / Q000175:diagnosis* / Q000601:surgery*; D005060:Europe; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D019651:Plastic Surgery Procedures / Q000592:standards; D012003:Rectal Fistula / Q000601:surgery