Krickenbeck Consensus for the Classification Grouping of Surgical Techniques and Scoring for Follow Up of Anorectal Malformations

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Standards for diagnostic procedures: International Classi- International grouping (Krickenbeck) of surgical proce-fication (Krickenbeck) dures for follow up

Major clinical groups

Perineal (cutaneous) fistula Rectourethral fistula Bulbar Prostatic Rectovesical fistula Vestibular fistula Cloaca No fistula Anal stenosis

Rare/regional variants

Pouch Colon Rectal atresia/stenosis Rectovaginal fistula H type fistula Others

Operative procedures

Perineal operation Anterior sagittal approach Sacroperinal procedure PSARP

Abdominosacroperi-neal pull-through Abdominoperineal pull-through Laparoscopic-assisted pull-through

Associated conditions

Sacral anomalies Tethered cord

Method for assessment of outcome established in Krickenbeck 2005 (patient age > 3 years, no therapy)

1. Voluntary bowel movements


Feeling of urge Capacity to verbalize Hold the bowel movement

2. Soiling


Grade 1 Occasionally (once or twice per week) Grade 2 Every day, no social problem Grade 3 Constant, social problem

3. Constipation


Grade 1 Manageable by changes in diet

Grade 2 Requires laxatives

Grade 3 Resistant to diet and laxatives

For further details see acknowledgement and chapters 8 and 25.

Preliminaray report in JPS 2005, 40:1521-1526.

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