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KMID : 0605920000060020106
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Journal of Korean Association of Pediatric Surgeons
2000 Volume.6 No. 2 p.106 ~ p.123
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Anorectal Malformatins In Korea- A Clinical Survey by the Korean Association of Pediatric Surgeons, 1999 -
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Lee Myung-Duk
Kim Sang-Yoon
Kim Woo-Ki
Kim In-Gu
Kim Jai-Eok
Kim Jae-Cheon
Kim Hyun-Hahk
Park Kwi-Won
Park Woo-Hyun
Song Young-Tack
Oh Soo-Myung
Yoo Su-Young
Lee Doo-Sun
Lee Suk-Koo
Lee Sung-Cheol
Chang Soo-Il
Jung Sang-Young
Jung Sung-Eun
Chung Eul-Sam
Jung Poong-Man
Cho Ma-Hae
Choi Kum-Ja
Chio Soon-Ok
Choi Seung-Hoon
Heo Young-Soo
Hong Jeong
Hwang Eui-Ho
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Abstract
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of the anorectal malformations (ARM) in Korea. Twenty-seven members of the Korean Association of Pediatric Surgeons were surveyed. The members completed a case registration form for each patient during the two years period of 1996-1997, and a questionnaire that contained their management preferences for primary and complicated patients. Twenty-four members of the 22 institutions registered 295 cases of the ARM, and 27 out of 34 members (77.1 %) responded to the questionnaire. The patients were classified by the Wingspread classification of ARM(1984). The case registration form was a modification of Wingspread workshop for the postoperative assessment and case registration. The male to female ratio was 1.7: 1. The average number of patients per surgeon was 6.1 cases per year. Prematurity( < 36 weeks) was present in 1.9 % of cases and low birth weight ( < 2.6 Kg) in 12.1 %. Among 187 male patients, 62 were higheR) type, 29 intermediate(l) type, 88 low(L), and 8 unclassified. In female, there were 2 cases of cloacal anomalies(C), 4 H type, 30 I type, 66 L type and 6 unclass ified. For male, 87.9 % of H and I type were operated by the Pena procedure, but only 7.9 % in L types. In female, all of C, H and I types, and 40.9 % of L type were done by the Pena procedure. One case expired (MR; 0.003%) as a result of surgical complication. Over-all complication rate was 12.5 %. Among 6 cases of reoperation, 4 were failed Pena procedures. Among 140 colostomies sigmoid colon was utilized in 75.7%, and loop colostomy was commonly used. Ten surgeons prefered primary maturation of the stoma. In conclusion, posterior sagittal anorectoplasty is popular for high types of ARM in this country, but considerable number of patients are still suffering from failed operations. For better understanding and analysis, necessity of prospective study by new classification was discussed
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KEYWORD
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Anorectal malformation, Imperforate anus, National surgery, Korea,
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