Evidence map›Paper›PMID 39560775›Full record

Trial reportPediatric surgery international2024

Effectiveness of primary repair for low anorectal malformations in Uganda.

Felix Oyania, Sarah Ullrich, Zane Hellmann, Caroline Stephens, Meera Kotagal, Sarah Jane Commander, Amy M Shui, Martin Situma, Charles Newton Odongo, Olivia Kituuka and 3 more

Abstract readEquivalence TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Pediatric surgery international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Felix OyaniaMbarara University of Science and Technology, P.O.Box 1410, Mbarara, Uganda. oyafel@icloud.com.
Sarah UllrichCincinnati Children's Hospital Medical Center, Cincinnati, USA.
Zane HellmannYale University, Connecticut, USA.
Caroline StephensUniversity of California, San Francisco, USA.
Meera KotagalCincinnati Children's Hospital Medical Center, Cincinnati, USA.
Sarah Jane CommanderDuke University, Durham, USA.
Amy M ShuiUniversity of California, San Francisco, USA.
Martin SitumaMbarara University of Science and Technology, P.O.Box 1410, Mbarara, Uganda.
Charles Newton OdongoSoroti University, Soroti, Uganda.
Olivia KituukaMakerere University, Kampala, Uganda.
Francis BajunirweMbarara University of Science and Technology, P.O.Box 1410, Mbarara, Uganda.
Doruk E OzgedizUniversity of California, San Francisco, USA.
Dan PoenaruMontreal Children's Hospital, McGill University Health Center, Montreal, QC, Canada.

Funding

University of California Launching Future Leaders in Global Health Research Training ProgramD43TW009343 · FIC · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CRAIG R COHEN, Sung-Jae Lee · 2017 to 2026
$14.7M
PIG AS A GENETIC MODEL FOR HUMAN OBESITYF32DK009343 · NIDDK · UNIVERSITY OF MINNESOTA TWIN CITIES · PI MENDIOLA, JOHN R · 1995 to 1995
–
FIC NIH HHS D43 TW009343The National Institute of Diabetes and Digestive and Kidney Diseases and the Fogarty International Center of the National Institutes of Health (NIH) and the University of California Global Health Institute (UCGHI) D43TW009343The Thrasher Research Fund TRF15700
6 · The paper itself

Abstract

backgroundAnorectal malformations (ARMs) have an incidence of up to 1 in 4000 live births and can require immediate neonatal surgery due to associated intestinal blockage. Due to limited surgical access, Ugandan children present late and undergo three separate staged operations: (1) initial colostomy formation; (2) repair of the ARM (called anoplasty); and (3) colostomy closure. Three operations result in long treatment duration, potential complications with each procedure, delays in care, and stigmata associated with colostomies. By offering primary repair for ARMs in a resource-limited setting, we expect to: reduce healthcare expenditure by families, length of treatment, length of hospital stay, frequency of hospital visits, and social rejection. MATERIALS AND

methodsA pragmatic clinical trial was performed examining the effectiveness of primary repair (prospective arm) and comparing it with the three-stage repairs (retrospective arm).

resultsOf the 241 patients included for analysis-157 patients had a three-stage repair, whereas 84 patients had one- or two-stage repair. The median [IQR age at the last surgery (days) was 730.0 (365.0, 1460.0) vs 180.0 (90.0, 285.0)] in three-stage and one- or two-stage repairs, respectively. There was no difference in postoperative complications compared to patients who had three-stage repair. Patients who had a two-stage repair had less time with colostomy than those with three-stage repair. Non-inferiority analysis demonstrated that the primary repair approach was non-inferior to the three-stage approach.

conclusionsPrimary repair for ARM is effective in low-income settings. It allows for less time with colostomy with no difference in post-operative complications. The decision on approach for treatment depends on the surgeon's experience and clinical judgment.

Indexed as

Anorectal MalformationsColostomyFemaleHumansInfant, NewbornLength of StayMalePlastic Surgery ProceduresPostoperative ComplicationsProspective StudiesRetrospective StudiesTreatment OutcomeUgandaAnorectal malformationsPragmatic clinical trialPrimary repairUganda

Identifiers

PMID39560775
PMCPMC12032398

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.