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Erschienen in:

01.12.2023 | Original Article

Fecal continence outcomes and potential disparities for patients with anorectal malformations treated at referral institutions for pediatric colorectal surgery

verfasst von: Samuel E. Rice-Townsend, Lauren Nicassio, Deb Glazer, Jeffrey Avansino, Megan M. Durham, Jason Frischer, Casey Calkins, Rebecca M. Rentea, Matthew Ralls, Megan Fuller, Richard J. Wood, Michael Rollins, Justin Lee, Katelyn E. Lewis, Ron W. Reeder, Caitlin A. Smith, for the Pediatric Colorectal, Pelvic Learning Consortium (PCPLC)

Erschienen in: Pediatric Surgery International | Ausgabe 1/2023

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Abstract

Purpose

Fecal incontinence is a problem for many patients born with an anorectal malformation (ARM) that can impact quality of life. It is unknown if racial, ethnic, and socioeconomic disparities relate to fecal continence in these children. We sought to examine outcomes and potential disparities in care.

Methods

We performed a multicenter retrospective study of children > 3y with ARM evaluated at sites participating in the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC). The primary outcome was fecal continence. We evaluated for associations between fecal continence and race, sex, age, and insurance status.

Results

509 patients with ARM from 11 institutions were included. Overall, 24% reported complete fecal continence, and fecal continence was associated with older age (p < .001). For school-aged children, 27% reported complete continence, while 53% reported none. On univariate analysis, patients with combined private and public insurance showed lower rates of continence when compared to those with private insurance (23 vs. 12%; p = 0.02). Age was associated with continence on univariate and multivariable analyses.

Conclusion

Rates of complete fecal continence in this population are low. Differences based on payor status may exist. There were no observed disparities related to sex and race. Further investigation is warranted to improve care for this patient population.

Level of evidence

III.

Type of study

Multi-institutional retrospective comparative study.

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Titel: Fecal continence outcomes and potential disparities for patients with anorectal malformations treated at referral institutions for pediatric colorectal surgery
verfasst von: Samuel E. Rice-Townsend
Lauren Nicassio
Deb Glazer
Jeffrey Avansino
Megan M. Durham
Jason Frischer
Casey Calkins
Rebecca M. Rentea
Matthew Ralls
Megan Fuller
Richard J. Wood
Michael Rollins
Justin Lee
Katelyn E. Lewis
Ron W. Reeder
Caitlin A. Smith
for the Pediatric Colorectal, Pelvic Learning Consortium (PCPLC)
Publikationsdatum: 01.12.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 1/2023
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-023-05447-5

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Fecal continence outcomes and potential disparities for patients with anorectal malformations treated at referral institutions for pediatric colorectal surgery