Surgery

From Scan to Plan: Making Virtual Surgical Planning the Standard of Care for Ortho-oncology Operations
From Scan to Plan: Making Virtual Surgical Planning the Standard of Care for Ortho-oncology Operations 1024 281 Abbie Miller

“We deal in rarities,” says Thomas Scharschmidt, MD, director of the Pediatric Orthopedic Oncology Program at Nationwide Children’s Hospital and professor of Orthopedics at The Ohio State University. “When you consider that across the entire U.S. population, we have between 2,500 and 3,000 cases of primary malignant bone tumors each year, and only half of…

Surgical Repair of Cloacal Malformation Does Not Worsen Bladder Function
Surgical Repair of Cloacal Malformation Does Not Worsen Bladder Function 1024 683 Mary Bates, PhD

The complexity of the malformation, more than the surgical approach, determines post-operative urodynamics. Approximately 90% of girls with cloacal malformation exhibit some degree of bladder dysfunction. While associated conditions can impact bladder dynamics, the complex surgery required to repair cloacal malformation has also been hypothesized to cause bladder dysfunction. Strategies to repair cloacal malformation in…

Long-Term Bladder Management and Continence in Girls With Cloacal Malformation
Long-Term Bladder Management and Continence in Girls With Cloacal Malformation 1024 683 Pam Georgiana
Molly Fuchs, MD

New insights on outcomes and quality of life from Nationwide Children’s comprehensive study of pediatric patients. Over the last decade, surgical innovation has revolutionized the treatment of cloacal malformation, a congenital anomaly affecting the development of the gastrointestinal, urinary and reproductive systems in girls. This condition occurs when the rectum, vagina and urinary tracts fail…

Novel Brace for Hip Immobilization After Bladder Exstrophy Repair
Novel Brace for Hip Immobilization After Bladder Exstrophy Repair 150 150 Katie Brind'Amour, PhD, MS, CHES

An innovative orthopedic brace allows families to avoid the disadvantages of casts, external fixators and traction devices after bladder exstrophy surgery. After bladder exstrophy repair — a complicated surgery to move a baby’s bladder from outside of the abdomen to the inside — postoperative hip position can cause tension on the incisions, making pelvic immobilization…

Surgical Repair of Traumatic Hip Dislocations With Acetabular “Fleck” Signs
Surgical Repair of Traumatic Hip Dislocations With Acetabular “Fleck” Signs 1024 683 Mary Bates, PhD
Kevin Klingele, MD

Surgical hip dislocation with open labral repair produced excellent clinical outcomes in pediatric patients. The acetabular “fleck” sign is a radiographic finding indicative of significant labral injury in young patients with traumatic hip dislocations. In a new study, researchers from Nationwide Children’s Hospital show that treatment by surgical hip dislocation with open labral repair leads…

Turning Complications into Fuel for a New Approach to Better Outcomes
Turning Complications into Fuel for a New Approach to Better Outcomes 1024 418 Alaina Doklovic

A new web application enhances Morbidity and Mortality data storage and actively improves patient care. Morbidity and Mortality (M&M) Conferences are mandated meetings that occur regularly at all academic medical centers and are powerful opportunities for learning and reflection. These conferences have been around for decades and provide opportunities to learn from medical errors, complications…

Spinal Anesthesia – an Alternative for Infants Undergoing Surgery
Spinal Anesthesia – an Alternative for Infants Undergoing Surgery 1024 683 Pam Georgiana

A new study highlights the safety and efficacy of more than 1,000 surgeries using spinal anesthesia. Nationwide Children’s Infant Spinal Anesthesia Program, headed by Grant J. Heydinger, MD, a pediatric attending anesthesiologist in the Department of Anesthesiology & Pain Medicine, recently published the results of a multiyear study of spinal anesthesia for infants undergoing surgery…

When Surgery Does Not Go as Planned
When Surgery Does Not Go as Planned 1024 575 V. Rama Jayanthi, MD
Dr. Jayanthi standing in OR

A surgeon’s reflections on complications, trust and moving forward together.   I have been thinking back on my career and the instances where a patient developed a complication, and the surgery did not go as planned. Having a family state their child was better off before the surgery and seeing the significant emotional harm it…

Magnetically Controlled Limb Lengthening Devices Safe for Patients With Programmable Implantable Devices, Study Shows
Magnetically Controlled Limb Lengthening Devices Safe for Patients With Programmable Implantable Devices, Study Shows 1024 683 Erin Gregory
Dr. Iobst with patient

Recent study evaluated the safety and efficacy of using magnetically controlled intramedullary nails in patients with programmable implantable devices, shedding light on a previously unexplored area of orthopedic surgery. In a pivotal study published in the Strategies in Trauma and Limb Reconstruction, led by Christopher A. Iobst, MD, a pediatric orthopedic surgeon at Nationwide Children’s…

Legislation Associated With Reduction in Amount of Opioids Prescribed at Discharge
Legislation Associated With Reduction in Amount of Opioids Prescribed at Discharge 1024 681 Laura Dattner

Study shows a decrease after the 2017 Ohio Prescription Opioid Cap Law went into effect. The Ohio Opioid Cap Law, enacted on August 31, 2017, limited the total dose and duration of opioids that could be prescribed for minors. The anticipated benefit of cap laws in preventing opioid overdose, death and addiction was counterbalanced by fears…

Accelerating Pediatric Medical Device Innovation 
Accelerating Pediatric Medical Device Innovation  150 150 Erin Gregory

The Midwest Pediatric Device Consortium (MPDC) is a unique collective led by Nationwide Children’s Hospital and The Ohio State University, designed to facilitate the development, production, and distribution of pediatric medical devices. Comprising a diverse group of leaders in universities, healthcare systems, community organizations, and industry partners across Ohio, the MPDC is committed to transforming…

Surgical Hip Dislocation as a Treatment Modality in Children and Adolescents
Surgical Hip Dislocation as a Treatment Modality in Children and Adolescents 150 150 Pam Georgiana

What was once a complicated surgery has now become a safe and effective way to treat many hip conditions.   Treatment of hip conditions and disorders in children and adolescents can be tricky. Doctors must have a thorough understanding of the patient’s anatomy, growth plates, and blood supply, as well as the existence of any…

Safe, Minimally Invasive Upper Urinary Tract Surgery for Infants
Safe, Minimally Invasive Upper Urinary Tract Surgery for Infants 1024 575 Patti Doud
small baby with nose canula

Evidence supports robotic surgery as a safe approach to upper urinary tract procedures in infants 6 months or younger. While robotic surgery has risen in popularity and feasibility for procedures in both older children and adults alike, there has been little data to determine whether it’s a safe possibility for young children and infants. But…

Targeted Muscle Reinnervation Prevents Neuroma and Phantom Limb Pain in Children After Amputation
Targeted Muscle Reinnervation Prevents Neuroma and Phantom Limb Pain in Children After Amputation 1024 684 Lauren Dembeck

In certain cases, such as limb traumas and sarcomas, amputation may be chosen to optimize patients’ physical function. Persistent postamputation residual limb or “stump” pain and phantom limb pain can be debilitating and has been associated with prosthetic abandonment in patients who have undergone amputation. This pain is often secondary to symptomatic neuromas, tumor-like disorganized…

Creatine Supplements and the Youth Athlete
Creatine Supplements and the Youth Athlete 945 825 Natalie Wilson

Researchers at Nationwide Children’s Hospital found there is insufficient evidence that creatine supplementation is effective for consistently improving athletic performance in adolescents. They also identified a gap in knowledge of the long-term effects of creatine supplementation in this population. Creatine is naturally found in skeletal muscle and acts as an energy source during muscle activation.…

Investigating Caregiver Disclosure of Pediatric Urologic Surgery
Investigating Caregiver Disclosure of Pediatric Urologic Surgery 1024 575 Mary Bates, PhD
Toddler playing with toys

A survey reveals most caregivers plan to disclose urologic surgery to their child but would like more guidance from providers. Some pediatric urologic surgeries are performed early in childhood and with short-term follow-up. When children have surgery before the age of memory formation, it is up to their caregiver to disclose this surgery to them.…

Intraoperative Evaluation of Penile Blood Flow During Bladder Exstrophy
Intraoperative Evaluation of Penile Blood Flow During Bladder Exstrophy 150 150 Mary Bates, PhD

Laser angiography technology allows for real-time measurements of penile perfusion during exstrophy repair operations. In a new pilot study, researchers from the Pediatric Urology Midwest Alliance (PUMA) demonstrated that intraoperative laser angiography is a safe and easy method to evaluate penile perfusion during bladder exstrophy closure. The optimal technique for repair of bladder exstrophy in…

Reducing Opioid Prescriptions for Common Pediatric Urologic Procedures
Reducing Opioid Prescriptions for Common Pediatric Urologic Procedures 1024 682 JoAnna Pendergrass, DVM
smiling baby being held up by an adult

To address the national opioid epidemic, clinician-scientists developed a quality improvement initiative to achieve significant, long-term reductions in opioid prescriptions after common pediatric urologic procedures.   Opioids are commonly prescribed for pediatric urologic procedures. However, studies have reported a troubling practice of overprescribing opioids in pediatric health, contributing to the ongoing opioid epidemic. “There is…

The PROMISE Program Reduces Cardiac Arrests in High-Risk Patients
The PROMISE Program Reduces Cardiac Arrests in High-Risk Patients 600 400 Mary Bates, PhD

This proactive quality improvement initiative improved outcomes for high-risk pediatric cardiology patients undergoing cardiac intervention. Faculty within The Heart Center at Nationwide Children’s recently initiated proactive risk mitigation strategies to reduce post-procedural cardiac arrests in high-risk congenital heart patients. In a new paper, the team used quality improvement methodology to show that their efforts resulted…

Featured Researcher — Linda Baker, MD
Featured Researcher — Linda Baker, MD 150 150 Natalie Wilson

Linda Baker, MD, a renowned expert in prune belly syndrome (PBS), joined Nationwide Children’s as a research director and principal investigator in the Kidney and Urinary Tract Center and The Ohio State University as a clinical professor of Urology at the end of 2022. Dr. Baker has met, evaluated and cared for over 180 children…

5 Things to Know About Prune Belly Syndrome
5 Things to Know About Prune Belly Syndrome 1024 683 Abbie Miller
Linda Baker, MD

Linda Baker, MD, urologist, principal investigator, and one of the world’s foremost experts on prune belly syndrome, recently joined Nationwide Children’s Hospital as the co-director of the Kidney and Urinary Tract Center. She shares some important things to know about this rare disease. 1. Prune belly is a rare, congenital malformation. Prune belly syndrome (PBS)…

Bowel Management Program Improves Urinary Symptoms Associated with Pediatric Functional Constipation
Bowel Management Program Improves Urinary Symptoms Associated with Pediatric Functional Constipation 150 150 JoAnna Pendergrass, DVM

A one-week bowel management program can significantly improve urinary symptoms in children with functional constipation, possibly eliminating the need for extensive urologic testing. Molly Fuchs, MD, a urologist at Nationwide Children’s Hospital, and her research team recently demonstrated that a bowel management program (BMP) significantly improved urinary symptoms in children with functional constipation. Functional constipation…

The Heart Center Team Employs New Device to Remove High-Risk Blood Clot
The Heart Center Team Employs New Device to Remove High-Risk Blood Clot 1024 670 Emily Siebenmorgen

This first-in-pediatrics procedure was performed by Arash Salavitabar, MD, interventional cardiologist at Nationwide Children’s Hospital.  When a pediatric patient sought care for an accidental gunshot wound to the abdomen, a central line infection during his course at a large regional hospital led to a much more serious blood clot in his right atrium. His case…

The Latest Developments in Limb Lengthening and Reconstruction Research
The Latest Developments in Limb Lengthening and Reconstruction Research 1024 683 Katie Brind'Amour, PhD, MS, CHES
Dr. Iobst with patient

Orthopedic experts publish an invited review of the past year’s most significant papers in the field of limb deformity correction and lengthening. To aid clinicians and surgeons who don’t have time for an annual deep-dive into the literature of their subspecialty, The Journal of Bone & Joint Surgery publishes yearly reviews courtesy of invited guest…

When Functional Outcomes Are Achieved Post-Op, Do Patients and Families Care About Scarring?
When Functional Outcomes Are Achieved Post-Op, Do Patients and Families Care About Scarring? 1024 683 Abbie Miller

A recent editorial from Dr. Daniel DaJusta questions whether cosmetic concerns after surgery are primarily driven by surgeons, patients or parents. It is widely accepted that having a smaller, neater or less visible scar following surgery is a preferable cosmetic outcome to a large, ragged or highly visible scar. This is supported anecdotally by surgeons,…

NASPGHAN: New Guidance for Surgical Procedure Selection in Pediatric Chronic Pancreatitis
NASPGHAN: New Guidance for Surgical Procedure Selection in Pediatric Chronic Pancreatitis 899 450 Katie Brind'Amour, PhD, MS, CHES

Informed, multispecialty decision-making is essential to give children with chronic pancreatitis the best chance for long-term pain relief and improved quality of life, according to new guidance issued by the North American Society for Pediatric Gastroenterology, Hepatology & Nutrition.   Chronic pancreatitis has long been an underappreciated and underrecognized condition in children. Now, a NASPGHAN…

Practical, At-Home Parasacral Nerve Stimulation for Overactive Bladder in Children
Practical, At-Home Parasacral Nerve Stimulation for Overactive Bladder in Children 150 150 Mary Bates, PhD

A new regimen for parasacral transcutaneous electrical nerve stimulation (TENS) is manageable and results in subjective improvements, though objective improvements were modest. In a new study, researchers from Nationwide Children’s evaluated the effectiveness of a practical, at-home regimen of parasacral transcutaneous electrical nerve stimulation (TENS) for children with overactive bladder. Parasacral TENS involves electrical stimulation…

First Multicenter, Prospective Study of Surgical Approach and Short-term Outcomes in Patients Undergoing Total Pancreatectomy With Islet Autotransplantation
First Multicenter, Prospective Study of Surgical Approach and Short-term Outcomes in Patients Undergoing Total Pancreatectomy With Islet Autotransplantation 150 150 Lauren Dembeck

The goal of the prospective study is to critically evaluate current clinical practices to determine which should be adopted or abandoned. It will also provide an opportunity to evaluate patients’ quality of life after total pancreatectomy with islet autotransplantation.   For children and adults with debilitating pancreatitis that fails to respond to medical and endoscopic…

Postoperative Management of Flexor Tendon Injuries in Children
Postoperative Management of Flexor Tendon Injuries in Children 150 150 Mary Bates, PhD

One month of immobilization followed by a modified Duran protocol leads to good outcomes. Pediatric flexor tendon injuries can be challenging due to children’s smaller anatomy and possible treatment nonadherence. In adults, immediate to early active motion for flexor tendon repairs has become standard, as prolonged postoperative immobilization can lead to adhesion formation and joint…

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…

Cylinder Mitral Valve Construct is a Safe and Durable Alternative for Young Patients
Cylinder Mitral Valve Construct is a Safe and Durable Alternative for Young Patients 1024 752 Mary Bates, PhD
Top-down view of heart valves

The new technique could potentially reduce the number of lifetime surgeries required by these patients, researchers say. In a new study, researchers from Nationwide Children’s Hospital report that pediatric patients who underwent cylinder mitral valve construct, a new technique for replacing the mitral valve, had improved left ventricular function over time. In addition, there were…

Robotic Surgery Is Here to Stay
Robotic Surgery Is Here to Stay 150 150 Abbie Miller

A recent publication describes increases in the use of robotic surgery in children’s hospitals across the country.  The use of robotic surgery in tertiary children’s hospitals has been on the rise since the 2000s. In a recent publication, researchers from Nationwide Children’s Hospital sought to characterize the use and growth in acceptance of robotic surgeries…

5 Things to Know About Vertebral Body Tethering for Scoliosis
5 Things to Know About Vertebral Body Tethering for Scoliosis 150 150 Allan C. Beebe, MD and Crystal D. Seilhamer, FNP

As the surgical approach to scoliosis grows in popularity, understanding the pros, cons and contraindications becomes increasingly important. At the Center for Comprehensive Spine Care in the Department of Orthopedics at Nationwide Children’s Hospital, patients and providers are increasingly asking about vertebral body tethering for scoliosis. Traditionally, scoliosis is treated with a variety of modalities…

She for She: Supporting Women in Orthopaedics
She for She: Supporting Women in Orthopaedics 1024 575 Julie Samora, MD, PhD
Julie Samora, MD

Julie Balch Samora, MD, PhD, MPH, an orthopaedic surgeon at Nationwide Children’s Hospital and the hospital’s associate medical director for quality, is the 2021 President of the Ruth Jackson Orthopaedic Society – the leading international organization championing women in orthopaedics. This column was adapted from her presidential address.   Shalane Flanagan is an American long-distance…

Surgical Management of Recurrent Patellar Instability in the Pediatric Population
Surgical Management of Recurrent Patellar Instability in the Pediatric Population 1024 575 Mary Bates, PhD

Medial patellofemoral ligament reconstruction via the quadriceps turndown technique is safe and effective in young patients. In a new study, researchers from Nationwide Children’s Hospital demonstrate the safety and efficacy of the quadriceps turndown technique for medial patellofemoral ligament reconstruction in pediatric and adolescent patients. Patellar instability is a common knee condition in children and…

The First Opioid-Prescribing Guidelines for Children Who Require Surgery
The First Opioid-Prescribing Guidelines for Children Who Require Surgery 1024 573 Lauren Dembeck

Providers should recognize the risks of opioids, maximize nonopioid regimens, and educate families appropriately. The first opioid-prescribing guidelines to address the unique needs of children who require surgery have been published by an expert panel in JAMA Surgery. The new guidelines aim to help health care professionals caring for children and adolescents in the perioperative…

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.

A Quick and Reliable Method to Determine The Time to Full Weight Bearing in Patients Undergoing Intramedullary Limb Lengthening
A Quick and Reliable Method to Determine The Time to Full Weight Bearing in Patients Undergoing Intramedullary Limb Lengthening 1024 575 Lauren Dembeck

A new method to objectively measure bone healing may help the patient with an intramedullary lengthening nail make strides to full weight bearing status. Intramedullary limb lengthening is indicated for the treatment of limb length discrepancy and short stature. Traditionally, the procedure was done using external fixators, which must remain on the patient’s limb for…

How Do Parents and Surgeons Evaluate Treatment Options for Uncomplicated Appendicitis?
How Do Parents and Surgeons Evaluate Treatment Options for Uncomplicated Appendicitis? 1024 575 Natalie Wilson
Parent and provider at child's hospital bed

The most recent in a series of publications on management of uncomplicated appendicitis showed patients and families cited the same concerns when electing either surgery or nonoperative treatment. Antibiotics alone have been shown to successfully treat uncomplicated appendicitis in children. But patients, families and surgeons may differently evaluate risks and benefits of this treatment option.…

Race Is a Risk Factor for Postoperative Death in Apparently Healthy Children in United States
Race Is a Risk Factor for Postoperative Death in Apparently Healthy Children in United States 1024 683 Abbie Miller

African American children were nearly 3.5 times more likely to die within 30 days after surgery, compared to white peers. In a new study, published in Pediatrics, researchers have shown that being African American was strongly associated with a higher risk of postoperative complications and mortality among apparently healthy children. In fact, compared to their white peers,…

Determining Ureteropelvic Junction Obstruction Surgical Success Using Biomarkers
Determining Ureteropelvic Junction Obstruction Surgical Success Using Biomarkers 1024 575 Katie Brind'Amour, PhD, MS, CHES

Biomarkers initially found to differ among patients with ureteropelvic junction obstruction and healthy controls may also objectively gauge post-surgical resolution of obstruction. A follow-up study of a trial that initially identified four biomarkers that differ between healthy controls and pediatric patients about to undergo surgery for ureteropelvic junction obstruction (UPJO) has confirmed that two of…

American Academy of Pediatrics Releases First Policy Statement on Organ Transplants for Children with Intellectual, Developmental Disabilities
American Academy of Pediatrics Releases First Policy Statement on Organ Transplants for Children with Intellectual, Developmental Disabilities 1024 575 Katelyn Scott

Today, the American Academy of Pediatrics (AAP) has released its first policy statement addressing children with intellectual and developmental disabilities as organ transplantation recipients. The policy statement, published online today in Pediatrics, recommends that transplant teams consider both the cognitive and adaptive skills of a patient when determining if a transplant could be of benefit, and recognize that…

Open Reduction May Improve Acetabular Remodeling in Developmental Dysplasia of the Hip
Open Reduction May Improve Acetabular Remodeling in Developmental Dysplasia of the Hip 1024 575 Lauren Dembeck

Study of children who had reductions for developmental hip dysplasia at age 2 years or younger highlights differences in outcomes for open and closed reductions. In children under 2 years of age with developmental dysplasia of the hip, open reduction with capsulorrhaphy appears to improve acetabular remodeling more than closed reduction, according to a study…

Transforming Medical Science Through Research Affinity Groups
Transforming Medical Science Through Research Affinity Groups 150 150 Katie Brind'Amour, PhD, MS, CHES

Purposeful synergy drives the most meaningful medical science. Nephrology physician-scientists require tissue samples, urologists desire tests to know which patients truly require surgery, and basic scientists must find ways to meaningfully assess new animal models to yield clinically valuable data. If each of these professionals had a defined network of colleagues from the other disciplines…

Keeping Options Open in Complex Pediatric Nephrolithiasis
Keeping Options Open in Complex Pediatric Nephrolithiasis 1024 575 Lauren Dembeck

Urologists in the Pediatric Urology Midwest Alliance recently looked at how endoscopic assisted robotic pyelolithotomy could reduce the number of procedures for children with ureteropelvic junction obstruction. The Pediatric Urology Midwest Alliance (PUMA) recently published a new report demonstrating that endoscopic assisted robotic pyelolithotomy (EARP) is an acceptable treatment option for complex cases of pediatric…

Dentists Heeded FDA Warning on Codeine
Dentists Heeded FDA Warning on Codeine 1024 683 Mary Bates, PhD
open bottle of pills

An FDA black box warning directed at ENT doctors performing tonsil and adenoid surgeries also affected prescribing patterns by dentists. Codeine, an opioid analgesic, was popular in pediatrics because it was thought to be a safe alternative to morphine. However, in recent years, the drug has been found to have variability in therapeutic doses, with…

When Should Preoperative Neuromonitoring for Adolescent Idiopathic Scoliosis Be Used?
When Should Preoperative Neuromonitoring for Adolescent Idiopathic Scoliosis Be Used? 150 150 Abbie Miller

Study leads researchers to recommend against routine use of preoperative SSEP/TMS testing in cases of AIS requiring corrective surgery. Adolescent idiopathic scoliosis (AIS) is a coronal curvature of the spine that affects 1 to 3% of adolescents. Of these, a very small percentage – at most 0.5% – progress to the point of needing surgical…

Linking Structure and Function in Children With 22q11.2 Deletion Syndrome
Linking Structure and Function in Children With 22q11.2 Deletion Syndrome 1024 575 Kevin Mayhood

Children with 22q11.2 deletion syndrome commonly have velopharyngeal dysfunction (VPD), affecting speech and swallowing. A recent series of studies finds that anatomy of their soft palate and associated bony structures and muscles differ from children who don’t have the syndrome. The findings suggest that these differences may be associated with speech, hearing and middle ear…

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…

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