Department of Pediatric Surgery, Radboudumc - Amalia Children's Hospital, Route 618, Nijmegen, 6500 HB, the Netherlands.
Department of Pediatric Surgery, Princess Máxima Center for Paediatric Oncology, Utrecht, the Netherlands.
BMC Pediatr. 2021 Jan 27;21(1):57. doi: 10.1186/s12887-021-02514-5.
An Anorectal Malformation (ARM) is a rare congenital malformation, which requires proper correction to ensure the best long-term prognosis. These procedures are relatively infrequent and complex, in which a structured approach is important. Therefore, training on an affordable model could be beneficial.
A low-cost ARM model was developed. The base was reusable and the perineal body disposable. Both expert pediatric surgeons (Experts) and residents/fellows (Target group) were recruited for this study. After testing the model, they completed a questionnaire regarding the realism and didactic value of the model, using a 5-point Likert scale.
Forty-four participants were recruited (Target group n = 20, Experts n = 24). The model has high mean scores of 3.8-4.4 for the total group and even higher on several aspects by the Target group. The experts regarded the haptics and manipulation of the fistula less realistic than the Target group (3.7 versus 4.3, p = 0.021 and 4.2 versus 4.6, p = 0.047). It was considered to be a very good training tool (mean 4.3), without significant differences between the groups.
These results show general consensus that this model is a potent training tool for the component steps of the repair of an ARM with recto-perineal fistula by sagittal approach.
肛门直肠畸形（ARM）是一种罕见的先天性畸形，需要进行适当的矫正以确保最佳的长期预后。这些手术相对较少见且复杂，因此采用结构化的方法非常重要。因此，使用负担得起的模型进行培训可能会有所帮助。
开发了一种低成本的 ARM 模型。该模型的底座可重复使用，会阴体一次性使用。本研究招募了经验丰富的小儿外科医生（专家）和住院医师/研究员（目标群体）。在测试模型后，他们使用 5 分制量表完成了一份关于模型真实性和教学价值的问卷。
共招募了 44 名参与者（目标群体 n=20，专家 n=24）。该模型的总体平均得分为 3.8-4.4，目标群体的某些方面甚至更高。专家认为瘘管的触觉和操作不如目标群体真实（3.7 对 4.3，p=0.021 和 4.2 对 4.6，p=0.047）。它被认为是一种非常好的培训工具（平均得分为 4.3），并且在专家组之间没有显著差异。
这些结果表明，普遍认为该模型是一种有效的培训工具，可用于通过矢状入路修复直肠会阴瘘型 ARM 的各个组成步骤。
