Center for Colorectal and Pelvic Reconstruction

Outcomes of Colonic Pull-Through for Patients With Cloacal Exstrophy: Is it Really Helping Kids?
Outcomes of Colonic Pull-Through for Patients With Cloacal Exstrophy: Is it Really Helping Kids? 1024 683 Mary Bates, PhD

Collaborative study reveals infrequent utilization of the procedure and identifies factors correlated with success. Cloacal exstrophy is a rare grouping of congenital anorectal malformations. Although once nearly uniformly fatal, survival has increased significantly, and with it, the focus on long-term outcomes. In the last 15 years, a reconstructive surgery known as colonic pull-through has been…

Straightforward Stitch Technique Dramatically Reduces Post-Operative Anorectoplasty Complications
Straightforward Stitch Technique Dramatically Reduces Post-Operative Anorectoplasty Complications 150 150 Katie Brind'Amour, PhD, MS, CHES

The novel para-U-stitch keeps post-operative wound dehiscence to a minimum, helping patients with anorectal malformations avoid readmission, reoperation and infection. After recognizing a pattern of wound dehiscence and postoperative complications in patients with anorectal malformations (ARMs) repaired without a colostomy bag — meaning they stool directly through the surgical site as it heals — surgeons…

Study Shows 1 in 4 Girls Born With Anorectal Malformations Have Co-occurring Gynecologic Anomalies
Study Shows 1 in 4 Girls Born With Anorectal Malformations Have Co-occurring Gynecologic Anomalies 1024 575 Jessica Nye, PhD

Gynecological anomalies are common among girls with anorectal malformations (ARM) with or without associated vertebral, anorectal, cardiovascular, trachea-esophageal, renal and limb (VACTERL) anomalies. One in 5,000 live births have ARM and 20%-70% co-occur with other congenital anomalies, including VACTERL. For girls born with ARM, gynecologic congenital anomalies can occur, especially with more complex ARM. To…

Which Surgical Approach for Catheterizable Channels in Bowel and Bladder Management Is Best?
Which Surgical Approach for Catheterizable Channels in Bowel and Bladder Management Is Best? 150 150 Jessica Nye, PhD

Specific patient characteristics, such as appendix size, may help guide clinicians when deciding which surgical approach to use for patients in need of catheterizable channels for bladder and bowel management. Many patients with neurologic disorders experience urinary and fecal incontinence. The appendix or the transverse ileal tube can be repurposed as a catheterizable channel to…

High Rate of Urologic Anomalies in Children With Anorectal Malformations
High Rate of Urologic Anomalies in Children With Anorectal Malformations 150 150 Lauren Dembeck

Early recognition of urologic problems through proactive screening and urologic collaboration may help prevent of renal deterioration and allow for timely treatment in this population.   Researchers at Nationwide Children’s Hospital have recently demonstrated that urologic anomalies occur at a high rate in children with anorectal malformations and appear to increase in frequency with increasing…

A New Kind of Rectal Diversion in Classic Bladder Exstrophy
A New Kind of Rectal Diversion in Classic Bladder Exstrophy 1024 754 Jeb Phillips

  This article appeared in the Spring/Summer 2021 print issue. Download the full issue.   Medical illustrations by Mandy Root-Thompson for Nationwide Children’s Hospital Source: V. Rama Jayanthi, chief of Urology at Nationwide Children’s Hospital To learn more about the procedure and it’s applications, read A Surprising Approach to Classic Bladder Exstrophy.

Does Low Baseline Renal Volume Lead to Renal Insufficiency in Children With Cloacal Anomalies?
Does Low Baseline Renal Volume Lead to Renal Insufficiency in Children With Cloacal Anomalies? 1024 683 Lauren Dembeck

According to the results of a recent study published in Urology, children with cloacal anomalies have baseline renal volumes similar to those of children without cloacal anomalies, indicating that the increased risk of renal insufficiency in children with cloacal anomalies appears to be due to postnatal renal injury. “Before we can determine if surgical interventions or…

Redo Surgery After Anorectal Malformation Repair Can Improve Functional Outcomes
Redo Surgery After Anorectal Malformation Repair Can Improve Functional Outcomes 1024 575 Mary Bates, PhD

A reoperation can improve continence and quality of life in children still struggling with fecal incontinence following ARM repair. In a new study, researchers from Nationwide Children’s Hospital show that redo surgeries are   safe and may be an effective option for patients with fecal incontinence after an anorectal malformation repair. For many patients, a reoperation…

Botox Appears Safe for Treatment of Defecation Disorders
Botox Appears Safe for Treatment of Defecation Disorders 150 150 Kevin Mayhood

Anal botulinum toxin injections (Botox) have increasingly been used in children with functional anorectal and colonic disorders during the past 15 years. A study at Nationwide Children’s Hospital, combined with a review of published literature, shows this off-label use of Botox is safe and complications are rare. Complications occurred in less than 0.7% of 1332…

Type of Anorectal Malformation at Birth is Predictive of Fecal Continence
Type of Anorectal Malformation at Birth is Predictive of Fecal Continence 150 150 Kevin Mayhood

Study also finds fecal continence rates for children born with ARMs are lower than previously reported. Recently published research shows the rate of fecal continence among 4-year-olds who underwent surgery for an anorectal malformation (ARM) as infants averages 40%, and the type of malformation — which reflects severity — is predictive of the outcome. Though…

Predicting Urinary Continence For a Child With Anorectal Malformation
Predicting Urinary Continence For a Child With Anorectal Malformation 150 150 Kevin Mayhood

Researchers suggest objective, measurable factors can be used to provide families with reasonable expectations In a child born with an anorectal malformation (ARM), anatomical features including a low-complexity ARM, high sacral ratio and a normal spine each independently predicts the child has a higher chance of urinary continence, research at Nationwide Children’s Hospital shows. “When…

Worth It: Why Wrestling Through the Logistical Challenges of a Multidisciplinary Colorectal Center Matters
Worth It: Why Wrestling Through the Logistical Challenges of a Multidisciplinary Colorectal Center Matters 150 150 Jeb Phillips

Consider the complex case of a girl born with rectal, vaginal and urinary tracts fused into a common channel – a cloacal malformation. The child needs reconstructive procedures across three different organ systems and three different surgical specialties. It could take months or years to manage the surgeries needed for the colorectal portion, then the…

A High Risk of Urological Diagnosis in Anorectal Malformations
A High Risk of Urological Diagnosis in Anorectal Malformations 150 150 Jeb Phillips

Opening the Door to Adult Medicine
Opening the Door to Adult Medicine 1024 575 Katie Brind'Amour, PhD, MS, CHES

Care transition plans aren’t just for kids with congenital conditions anymore. Could your practice benefit from a proactive transition plan for all patients? In the shift from pediatric to adult care, young patients have the responsibility to adjust to a new life of self-management. But health care providers also play an important role in this…

Saving Constipation Treatment Costs With a Bowel Management Program
Saving Constipation Treatment Costs With a Bowel Management Program 1024 575 Jeb Phillips
Simple illustrated diagram of the GI track with organs colorized and body outline and background in blue

A protocolized approach significantly reduced ED visits and hospital admissions for children with chronic constipation – and became a driver for surgical referrals. If hospitals are willing to foot the bill for staffing and start-up costs, a structured bowel management program for children with chronic severe constipation likely saves both individual and institutional health care…

In Sight: Three Procedures, One Surgery
In Sight: Three Procedures, One Surgery 388 320 Jeb Phillips

Colorectal Surgery, Urology and Gynecology coordinate to save tissue and time. A child with a complex colorectal and pelvic condition may require several surgeries over months or years before they are able to successfully manage their urine and stool. With advance planning and coordination it can be possible to treat many issues at once and…

InSight: Restoring Normal Habits
InSight: Restoring Normal Habits 471 285 Tiasha Letostak, PhD

SACRAL NERVE STIMULATION (SNS) is a new treatment that helps control urinary incontinence and fecal soiling. For some children, the nerves that control urination and bowel movements do not work correctly. The SNS unit consists of a small, safe battery and wire under the skin and sends signals to the sacral nerve. The signals help restore…