Reconsidering Diagnosis, Treatment, and Postoperative Care in Children with Cloacal Malformations.
J Pediatr Adolesc Gynecol
; 34(6): 773-779, 2021 Dec.
Article
em En
| MEDLINE
| ID: mdl-34419606
ABSTRACT
Cloacal malformations are among the most complex types of anorectal malformation and are characterized by the urological, genital, and intestinal tracts opening through a single common channel in the perineum. Long-term outcome is affected by multiple factors, which include anatomical variants of the malformation itself, associated anomalies, and the surgical approach. Reconsidering these variables and their influence on "patient important" function might lead to strategies that are more outcome-driven than focused on the creation of normal anatomy. Key outcomes reflect function in each of the involved tracts and the follow-up needed should therefore not only include the classical fields of colorectal surgery and urology but also focus on items such as gynecology, sexuality, family-building, and quality of life as well as other psychological aspects. Involving patients and families in determining optimal treatment strategies and outcome measures could lead to improved outcomes for the individual patient. A strategy to support delivery of personalized care for patients with cloacal malformations by aiming to define the best functional outcomes achievable for any individual, then select the treatment pathway most likely deliver that, with the minimum morbidity and cost, would be attractive. Combining the current therapies with ongoing technological advances such as tissue expansion might be a way to achieve this.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Qualidade de Vida
/
Malformações Anorretais
Tipo de estudo:
Diagnostic_studies
Aspecto:
Patient_preference
Limite:
Animals
/
Child
/
Humans
Idioma:
En
Revista:
J Pediatr Adolesc Gynecol
Assunto da revista:
GINECOLOGIA
/
PEDIATRIA
Ano de publicação:
2021
Tipo de documento:
Article
País de publicação:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
/
US
/
USA