Assessing the previously repaired patient with an anorectal malformation who is not doing well

Lane, Victoria A.; Calisto, Juan L.; deBlaauw, Ivo; Calkins, Casey M.; Samuk, Inbal; Avansino, Jeffrey R.

doi:10.1016/j.sempedsurg.2020.150995

Cited by 7 publications

(22 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Evaluation of an ARM patient who is not doing well postrepair starts with obtaining a detailed history including symptoms, current and past medical therapies, and surgical interventions. 8 This patient was referred for anal stricture, which occurs in 20 to 30% of ARMs. 9 A review of 95 redo operations in cloaca by this paper's senior author showed that the most common indication for revision was a persistent urogenital sinus in which the rectal component only was repaired (46), followed by a rectal stricture or atresia (45), acquired vaginal stricture or atresia (45) mislocated rectum (36), urethrovaginal fistula (16), rectal prolapse (12), urethral atresia or stricture (7), and rectovaginal fistula (5), with most patients having greater than one indication.…”

Section: Discussionmentioning

confidence: 99%

Where Is the Vagina? A Rectal Stricture after a Presumed Cloacal Repair Turns Out to be the Mobilized Vagina and a Missed High Rectovaginal Fistula

Jacobs

Tiusaba

Bokova

et al. 2022

European J Pediatr Surg Rep.

View full text Add to dashboard Cite

We present a case of a rare complication in a 10-month-old female referred to our institution for an anal stricture after primary cloacal repair as an infant. Multimodal imaging, careful physical exam, and endoscopic evaluation revealed her vagina had been pulled through to the location of her anal sphincter muscle complex. We describe the correction of this problem, including identification of her rectum.

show abstract

Section: Discussionmentioning

confidence: 99%

Where Is the Vagina? A Rectal Stricture after a Presumed Cloacal Repair Turns Out to be the Mobilized Vagina and a Missed High Rectovaginal Fistula

Jacobs

Tiusaba

Bokova

et al. 2022

European J Pediatr Surg Rep.

View full text Add to dashboard Cite

show abstract

“…For 10 of the 35 children in this review, their ARM type was not documented; the presence of spinal anomalies not reported in 23; and the primary operative repair unknown for the majority (33 children, 95%). Accurate understanding of ARM type is essential not only to facilitate precise operative repair, but also to prognosticate continence potential 7,10 . The ARM Index may be used to predict continence in patients with an ARM.…”

Section: Discussionmentioning

confidence: 99%

“…Fecal incontinence following ARM repair is commonly considered to result from either severe constipation with overflow soiling, or "true" incontinence, when the patient's anatomic features are considered insufficient to support fecal control. 7,24 Heikenen et al 16 focused on colonic motility in children with fecal incontinence refractory to medical management following ARM repair. High-amplitude propagated contractions were identified in all subjects, 81% of which propagated to the neorectum.…”

Section: Colonic Manometry Outcomes In Relation To Bowel Functionmentioning

confidence: 99%

See 1 more Smart Citation

Post‐operative colonic manometry in children with anorectal malformations: A systematic review

Evans-Barns

Tien

Trajanovska

et al. 2022

Neurogastroenterology Motil

View full text Add to dashboard Cite

Background Children with anorectal malformations may experience constipation and fecal incontinence following repair. The contribution of altered anorectal function to these persistent symptoms is relatively intuitive; however, colonic motility in this cohort is less well understood. Manometry may be used to directly assess colonic motility. Purpose The purpose of this systematic review was to synthesize the available evidence regarding post‐operative colonic motility in children with anorectal malformations and evaluate the reported equipment and protocols used to perform colonic manometry in this cohort. This systematic review was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA). We conducted a systematic review of four databases: Embase, MEDLINE, PubMed, and the Cochrane Library (1st January 1985–22nd July 2021). Studies reporting colonic manometry performed in children following anorectal malformation repair were assessed for eligibility. Data were extracted independently by two authors. Four studies were eligible for inclusion. Of the combined total cohort of 151 children, post‐operative colonic manometry was conducted in 35. Insufficient reporting of medical characteristics, bowel function, and manometric outcomes restricted comparison between studies, and limited clinical applicability. No results from high‐resolution colonic manometry were identified. Despite the prevalence of post‐operative bowel dysfunction in children with repaired anorectal malformations, this systematic review highlighted the markedly limited evidence regarding post‐operative colonic motility. This cohort may benefit from assessment with high‐resolution techniques; however, future work must emphasize adherence to standardized manometry protocols, and include robust reporting of surgical characteristics, bowel function, and manometric outcomes.

show abstract

“…Patients were selected for the TH visit option based on the following inclusion criteria: previously established with the Comprehensive Colorectal Center, anatomy previously delineated on IP evaluation (examination under anesthesia with imaging), and those without acute issues that might require inpatient admission. 17,18 Patients who required initial evaluation or those with acute issues requiring IP examination were not offered a TH visit. If imaging or laboratory studies were required, these were performed at nearby facilities on the days before the TH appointments.…”

Section: Methodsmentioning

confidence: 99%

Leveraging Collaboration in Pediatric Multidisciplinary Colorectal Care Using a Telehealth Platform

López

Svetanoff

Rosen

et al. 2021

The American Surgeon

View full text Add to dashboard Cite

Purpose Pediatric colorectal problems often require complex multidisciplinary care (MDC), which has been affected by the SARS-CoV-2-2019 (COVID-19) pandemic. We describe our utilization and implementation of telehealth (TH) for pediatric colorectal surgery MDC visits and collate patient satisfaction using TH compared to in-person (IP) visits. Methods Implementation of a single-institution MDC TH platform to perform patient visits on February 1, 2020 was studied. Following 6 months of implementation, TH visits’ characteristics were compared with IP visits in the 3 months before implementation by patient volume, length of clinic visits, and patient satisfaction survey results. Results Before implementation, 152 (100%) of clinic visits were IP. During the implementation, 87 (37.7%) were TH visits. Seventy-four (49%) were MDC visits, 17 (23%) of these using the TH platform. Each TH visit’s median length was 25 minutes (IQR 15-30), while the median length of IP visits was 45 minutes (IQR 30-45). Pre-implementation satisfaction scores were 88.6% positive, while satisfaction scores after implementation were 96.8% positive. None of the patients who utilized the TH platform had an unplanned hospital admission within 24 hours of being seen. Conclusion Our experience demonstrates that the TH platform can provide an efficient avenue for established patients and families to receive highly complex multidisciplinary follow-up care. High levels of patient satisfaction indicated that TH should become part of the routine care plan for patients who require long-term or consistent follow-up.

show abstract

Assessing the previously repaired patient with an anorectal malformation who is not doing well

Cited by 7 publications

References 49 publications

Where Is the Vagina? A Rectal Stricture after a Presumed Cloacal Repair Turns Out to be the Mobilized Vagina and a Missed High Rectovaginal Fistula

Where Is the Vagina? A Rectal Stricture after a Presumed Cloacal Repair Turns Out to be the Mobilized Vagina and a Missed High Rectovaginal Fistula

Post‐operative colonic manometry in children with anorectal malformations: A systematic review

Leveraging Collaboration in Pediatric Multidisciplinary Colorectal Care Using a Telehealth Platform

Contact Info

Product

Resources

About