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Multi-institutional review of bowel management strategies in children with anorectal malformations
- Source :
- Journal of Pediatric Surgery. 55:2752-2757
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- To describe current bowel management program (BMP) strategies in anorectal malformation (ARM) patients based on patient-level predictors using data from a multi-institutional consortium.Patient bowel function and BMP were reviewed from Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) data. The PCPLC is comprised of multidisciplinary specialists researching colorectal and pelvic disorders. Seven US institutions submitted de-identified clinical data on ARM patients into a centralized patient registry.The primary ARM of 624 patients was categorized into Mild (45.2%), Moderate (40.4%) or Complex (14.2%) anomaly classifications. Patient-specific BMP were examined based on age and on the presence of spinal cord/sacral anomalies. 418 (67%) enrolled patients were prescribed BMP (5 yo 56.4%; ≥5-12 yo 86.7%; ≥12 81.5%). Constipation was the primary chief complaint (80.2%). Forty percent of patients on a BMP were toilet trained and approximately one-half (48.5%) reported daytime stool accidents. Secondary surgical interventions for antegrade continence enemas (ACE) were examined; 14.5% of patients employed ACE strategies and utilization increased with age and varied based on anatomic anomalies.This is the first report on BMP strategies for patients with ARM from the Pediatric Colorectal and Pelvic Learning Consortium. Individual patient characteristics are explored for their impact on bowel management strategy utilization.IV.
- Subjects :
- medicine.medical_specialty
Bowel management
Patient characteristics
Enema
03 medical and health sciences
0302 clinical medicine
030225 pediatrics
Internal medicine
Humans
Medicine
Bowel function
Child
Retrospective Studies
Patient registry
business.industry
General Medicine
Evidence-based medicine
Anorectal Malformations
Intestines
030220 oncology & carcinogenesis
Pediatrics, Perinatology and Child Health
Surgery
business
Constipation
Surgical interventions
Fecal Incontinence
Subjects
Details
- ISSN :
- 00223468
- Volume :
- 55
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Surgery
- Accession number :
- edsair.doi.dedup.....98f6ef15e0b9fd0287e0a862fb2e05a0