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Pediatric Surgery International

, Volume 35, Issue 2, pp 233–237 | Cite as

Transition of care: a growing concern in adult patients born with colorectal anomalies

  • Shannon Acker
  • Alberto Peña
  • Duncan Wilcox
  • Veronica Alaniz
  • Andrea BischoffEmail author
Original Article

Abstract

Purpose

Traditionally, the care of children and adults has been arbitrarily separated into pediatric and adult medicine and surgery. Despite progress in pediatric surgical techniques, patients born with congenital anomalies still suffer from significant functional sequelae, which persist into adulthood. We aim to describe some of the most common problems experienced by adult patients with congenital colorectal malformations.

Methods

Following IRB approval, we performed a retrospective database review of all adult patients who were treated by our group from 1983 until 2017.

Results

We identified 88 cases. 51 patients had ARM, 18 cloacas, 9 presacral masses, 3 HD, 2 spina bifida and 5 with other diagnoses (3 vaginal anomalies, 1 cloacal exstrophy, 1 obstructed seminal vesical). The specific problems addressed were: complications from previous operations (41), rectal prolapse (25), fecal incontinence (11), gynecologic concerns (12), urologic concerns (6), and recurrent recto urogenital fistula (3). We performed 83 surgical interventions, including 13 rectal prolapse repair, 13 continent appendicostomies, 44 PSARP or redo PSARP, 11 resections of presacral masses, 11 vaginoplasties, 2 examinations under anesthesia, and 2 Mitrofanoff procedures. Five patients were treated medically (bowel management program, obstetric, urologic evaluation).

Conclusion

There is a growing need to better prepare adult providers to assume the care of patients born with congenital colorectal disease as these patients transition to adulthood. A collaboration between specialized pediatric referral centers with adult colorectal surgeons, urologists and gynecologists is a potential pathway for the adequate transition of care.

Keywords

Transition of care Anorectal malformation Hirschsprung 

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Shannon Acker
    • 1
  • Alberto Peña
    • 1
  • Duncan Wilcox
    • 2
  • Veronica Alaniz
    • 3
  • Andrea Bischoff
    • 1
    Email author
  1. 1.Department of Pediatric Surgery, International Center for Colorectal and Urogenital Care, Children’s Hospital ColoradoUniversity of ColoradoAuroraUSA
  2. 2.Department of Pediatric Urology, International Center for Colorectal and Urogenital CareChildren’s Hospital ColoradoAuroraUSA
  3. 3.Division of Pediatric and Adolescent Gynecology, International Center for Colorectal and Urogenital CareChildren’s Hospital ColoradoAuroraUSA

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