Collection
Pediatric Colorectal and Pelvic Reconstruction
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Neonates and infants under about 3 months of age tolerate anal dilations well, but for older patients dilations become a greater psychological stressor for parents and patients. — Caitlin Smith, Update Course 2021: PEDS COLORECTAL CONSORTIUM CONCLUSIONS · 17:39
Lasting impact on children with an anorectal malformations with proper surgical preparation, respect for anatomic principles, and precise surgical management
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Publication date: Available online 8 November 2020Source: Seminars in Pediatric SurgeryAuthor(s): Rebecca M. Rentea, Andrea T. Badillo, Stuart Hosie, Jonathan R. Sutcliffe, Belinda Dickie
article · Nov 2020
Colorectal Quiz Episode 15: Bowel Management in Spinal Patients - Need for a UrologistPart 1
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Bowel management can be difficult on its own but for patients with spinal disorders, it can be exponentially more complex. Today, Dr. Levitt and Dr. Frischer discuss bowel management for this subset of patients and they brought some friends
podcast17:26 · Jun 2021
Colorectal Quiz Episode 16: Bowel Management in Spinal Patients - Need for a Urologist Part 2
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Bowel management can be difficult on its own but for patients with spinal disorders, it can be exponentially more complex. Today, Dr. Levitt and Dr. Frischer discuss bowel management for this subset of patients and they brought some friends
podcast14:18 · Jul 2021
Update Course Rewind: 2021 Top Ten Key Takeaways
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The 9th annual Pediatric Surgery Update Course was held as a webinar on August 27, 2021. We had a lot of lively discussion and engaging presentations on the latest updates in pediatric surgery. In this video we are reviewing the top ten key
video16:02 · Oct 2021
Update Course Rewind: Pediatric Colorectal Consortium 2021
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Did you miss the Pediatric Colorectal and Pelvic Learning Consortium session from our 2021 Pediatric Surgery Update Course? Don’t worry, in this Update Course Rewind Dr. Rebecca Rentea from Children's Mercy at Kansas City and Dr. Caitlin Sm
podcast14:55 · Apr 2022
Update Course 2021: PEDS COLORECTAL CONSORTIUM CONCLUSIONS
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In this session from the 2021 Update Course, Dr. Rebecca Rentea, MD from Children's Mercy at KansasCity and Dr. Caitlin Smith, MD from Seattle Children's reviewed the latest literature including timing of surgery for patients with ARM and t
video36:32 · May 2022
Does presence of a VACTERL anomaly predict an associated gynecologic anomaly in females with anorectal malformations?
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Infographic by Dr. Cecilia Gigena
"Does presence of a VACTERL anomaly predict an associated gynecologic anomaly in females with anorectal malformations?: A Pediatric Colorectal and Pelvic Learning Consortium Study"
Authors: Hira Ahm
article · Apr 2023
¿La presencia de VACTERL predice anomalías ginecológicas en pacientes femeninas con malformación anorectal (MAR)?
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Infografía por Cecilia Gigena
"¿La presencia de VACTERL predice anomalías ginecológicas en pacientes femeninas con malformación anorectal (MAR)?"
Autores: Hira Ahmad, Richard J. Wood, Jeffrey R. Avansino, Casey M. Calkins, Belinda Hsi
article · Apr 2023
Enfermedad Inflamatoria intestinal asociada a Hirschsprung
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Nuevo articulo que tenes que conocer por Cecilia Gigena
“Enfermedad Inflamatoria intestinal asociada a Hirschsprung: Un estudio multicéntrico del grupo de interés de la enfermedad de Hirschsprung de APSA” Sutthatarn P et. al.
Autores: P
video0:58 · Jun 2023
Hirschsprung-associated inflammatory bowel disease: A multicenter study from the APSA Hirschsprung disease interest group
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Pattamon Sutthatarn, Eveline Lapidus-Krol, Caitlin Smith, Ihab Halaweish, Kristy Rialon, Matthew W. Ralls, Rebecca M. Rentea, Mary B. Madonna, Candace Haddock, Ana M. Rocca, Ankush Gosain, Jason Frischer, Hannah Piper, Allan M. Goldstein, P
article · Jul 2023
Does Delayed Diagnosis of Hirschsprung Disease Impact Post-operative and Functional Outcomes?
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Sarah Ullrich, Kelly Austin, Jeffrey R Avansino, Andrea Badillo, Casey M Calkins, Rachel C Crady, Megan M Durham, Megan K Fuller, Ankur Rana, Ron W Reeder, Rebecca M Rentea, Michael D Rollins, Payam Saadai, K Elizabeth Speck, Richard J Wood
article · Aug 2024
Does Delayed Diagnosis of Hirschsprung Disease Impact Post-operative and Functional Outcomes? A Multi-Center Review From the Pediatric Colorectal and Pelvic Learning Consortium
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Sarah Ullrich, Kelly Austin, Jeffrey R Avansino, Andrea Badillo, Casey M Calkins, Rachel C Crady, Megan M Durham, Megan K Fuller, Ankur Rana, Ron W Reeder, Rebecca M Rentea, Michael D Rollins, Payam Saadai, K Elizabeth Speck, Richard J Wood
video1:09 · Oct 2024
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Expert statements from the recordings in this collection.
Does Delayed Diagnosis of Hirschsprung Disease Impact Post-operative and Functional Outcomes? A Multi-Center Review From the Pediatric Colorectal and Pelvic Learning Consortium
The Pediatric Colorectal and Pelvic Learning Consortium conducted a multi-center retrospective review from 2017 to 2023 examining the relationship between delayed diagnosis of Hirschsprung disease and postoperative/functional outcomes.
Alex Halpern0:12
The study included 679 patients with Hirschsprung disease from 14 different sites.
Alex Halpern0:23
Increased age at diagnosis was associated with a greater likelihood of undergoing fecal diversion after initial pull-through procedure.
Alex Halpern0:29
Increased age at diagnosis was associated with an increased risk of constipation or incontinence requiring intervention postoperatively.
Alex Halpern0:39
No association was found between age at diagnosis and 30-day complication rate after initial pull-through.
Alex Halpern0:49
No association was found between age at diagnosis and need for pull-through revision.
Alex Halpern0:49
Delayed diagnosis of Hirschsprung disease affects certain postoperative and functional outcomes in patients.
Alex Halpern0:58
Colorectal Quiz Episode 15: Bowel Management in Spinal Patients - Need for a UrologistPart 1
About 5% of colorectal work is surgical and the rest is bowel management.
MiraLax softens stool but does not provide a 'push' to expel it, which can leave the colon full of soft stool.
Christine Warner6:16
Senna and bisacodyl are the two medications that provide a 'kick' or push for stool expulsion; everything else is a stool softener.
Marc Levitt6:59
MiraLax is problematic for patients with anorectal malformations who need fullness to detect stool, because it makes soft stool that 'mushes out' without discrete sensation.
Marc Levitt7:15
Senna-induced perineal rash is thought to be a chemical burn rather than a true allergy, presenting with blistering.
Jason Frischer5:30
Senna rash is treated with silver sulfadiazine and resolves with time; some patients tolerate senna upon reintroduction.
Jason Frischer5:38
Timing senna doses in the early morning so that bowel movements occur during the day (when diapers are changed promptly) reduces the risk of senna rash.
Jason Frischer5:47
Senna rash may be related to the formulation (tablet, liquid, or chocolate squares) or to prolonged contact with stool, particularly overnight.
Glycerin is generally better tolerated than castile soap for enemas in children; castile soap commonly causes cramping and discomfort.
Wendy Lewis9:10
A Malone appendicostomy provides tube-free access for antegrade enemas via daily catheterization of the channel.
Rebecca Rentea9:39
Children with spinal differences may need bladder access later in life, and the appendix is the preferred conduit for a Mitrofanoff urinary channel.
Rebecca Rentea9:49
Coordination with urology from the beginning of bowel management planning is essential in spinal patients to preserve the appendix for potential urologic reconstruction.
Marc Levitt10:02
A cecostomy tube (placed laparoscopically or by interventional radiology) provides direct access to the cecum for antegrade enemas and preserves the appendix for future reconstruction.
Rebecca Rentea11:53
A non-plicating, non-trimmed Malone appendicostomy (tip of appendix sewn to right lower quadrant with a balloon tube, without plication or trimming) preserves the appendix for potential future urologic use or splitting.
Marc Levitt12:22
Urologists prefer an appendix of at least 5 cm length for a Mitrofanoff; shorter appendices are not suitable for urologic use.
Marc Levitt13:36
An appendix of 2 cm is too short for either colorectal or urologic use; 5 cm goes to urology; 7 cm may be splittable (2 cm for colorectal, 5 cm for urology); longer appendices are certainly splittable.
Marc Levitt13:16
For urologic reconstruction, the appendix is preferred over a Monti channel made from small bowel for long-term outcomes.
Marc Levitt14:07
A neo-Malone can be created from a flap of colon if the appendix is used for urologic purposes.
Marc Levitt14:18
Taking down a cecostomy tube is relatively easy and leaves the appendix free for subsequent use.
Marc Levitt15:38
Bisacodyl can be administered as an enema or suppository in infants.
Jason Frischer8:31
Colorectal Quiz Episode 16: Bowel Management in Spinal Patients - Need for a Urologist Part 2
When a 7 cm appendix is shared between urology and colorectal surgery, the urologist typically takes 6.25 cm leaving only 0.75 cm for colorectal use
Jason Frischer1:17
Urologists typically take a 70/30 split when sharing the appendix
The colorectal team benefits from using the appendix portion closer to the cecum which has a stronger blood supply
Jason Frischer1:55