title: Functional Outcome of Anorectal Malformations and Associated Anomalies in Era of Krickenbeck Classification.
abstract: OBJECTIVE
  To describe the management and functional outcome of anorectal malformations and associated anomalies according to Krickenbeck classification.
  
  
  METHODS
  Case series.
  
  
  METHODS
  The Aga Khan University Hospital, Karachi, from January 2002 to December 2012.
  
  
  METHODS
  Anorectal anomalies were classified according to Krickenbeck classification. Data was collected and proforma used regarding the primary disease associated anomalies, its management and functional outcome, according to Krickenbeck classification. Cases included were: all those children with imperforate anus managed during the study period. Qualitative variables like gender and functional outcome were reported as frequencies and percentages. Quantitative variables like age were reported as medians with interquartile ranges.
  
  
  RESULTS
  There were 84 children in study group. Most common associated anomaly was cardiac (38%), followed by urological anomaly (33%). All children were treated by Posterior Sagittal Anorectoplasty (PSARP). Fistula was present in 64 out of 84 (76%) cases. The most common fistula was rectourethral (33%), followed by recto vestibular (31%). According to Krickenbeck classification, continence was achieved in 62% children; however 27% children were constipated, followed by 12% children having fecal soiling.
  
  
  CONCLUSIONS
  Functional outcome of anorectal malformation depends upon severity of disease. A thorough evaluation of all infants with ARM should be done with particular focus on cardiovascular (38%) and genitourinary abnormalities (33%).
authors.affiliation: Department of Surgery, The Aga Khan University Hospital, Karachi.
authors.forename: Saqib Hamid
authors.initials: SH
authors.lastname: Qazi
authors.affiliation: Department of Surgery, The Aga Khan University Hospital, Karachi.
authors.forename: Ahmad Vaqas
authors.initials: AV
authors.lastname: Faruque
authors.affiliation: Department of Surgery, The Aga Khan University Hospital, Karachi.
authors.forename: Muhammad Arif
authors.initials: MA
authors.lastname: Mateen Khan
authors.affiliation: Department of Medical Student, The Aga Khan University Hospital, Karachi.
authors.forename: Umama
authors.initials: U
authors.lastname: Saleem
mesh_terms: D000015:Abnormalities, Multiple / Q000145:classification / Q000601:surgery*; D001003:Anal Canal / Q000002:abnormalities* / Q000601:surgery; D000071056:Anorectal Malformations / Q000175:diagnosis* / Q000601:surgery*; D002675:Child, Preschool; D003125:Colostomy; D005260:Female; D005402:Fistula / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010154:Pakistan; D019651:Plastic Surgery Procedures / Q000379:methods*; D012007:Rectum / Q000002:abnormalities* / Q000601:surgery; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome