Impaired growth outcomes in children with congenital colorectal diseases

Veras, Laura V.; Chotai, Pranit N.; Tumen, Andrew; Gosain, Ankush

doi:10.1016/j.jss.2018.03.069

Cited by 5 publications

(7 citation statements)

References 19 publications

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“…However, Veras et al demonstrated that children with colorectal diseases, including HD, with public insurance had a higher risk of impaired growth compared with patients with private insurance. 30 Further, there is data showing that payer status Further, our study found no significant association between preoperative HAEC and postoperative HAEC, which is contradictory to other reports. 8,10 This discrepancy might be explained by the lack of a consensus definition of HAEC.…”

Section: Discussioncontrasting

confidence: 99%

Comparison of Hirschsprung Disease Characteristics between Those with a History of Postoperative Enterocolitis and Those without: Results from the Pediatric Colorectal and Pelvic Learning Consortium

et al. 2020

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Introduction The current understanding of Hirschsprung-associated enterocolitis (HAEC) is based mainly on single-center, retrospective studies. The aims of this study are to determine risk factors for postoperative HAEC using the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) database. Materials and Methods We performed a multicenter, retrospective, case–control study of children with Hirschsprung disease (HD) who had undergone a pull-through procedure and were evaluated at a PCPLC member site between February 2017 and March 2020. The cohort with a history of postoperative HAEC was compared with that without postoperative episodes of HAEC to determine relevant associations with postoperative HAEC. Results One-hundred forty of 299 (46.8%) patients enrolled had a history of postoperative HAEC. Patients with a rectosigmoid transition zone had a lower association with postoperative HAEC as compared with those with a more proximal transition zone (odds ratio [OR]: 0.46, 95% confidence interval [CI]: 0.26, 0.84, p < 0.01). Private insurance was protective against postoperative HAEC on univariate analysis (OR: 0.62, 95% CI: 0.38, 0.99, p = 0.047), but not on multivariate analysis (OR: 0.62, 95% CI: 0.37, 1.04, p = 0.07). Preoperative HAEC was not associated with the development of postoperative HAEC. Conclusion Patients with a rectosigmoid transition zone have less postoperative HAEC compared with patients with a more proximal transition zone. Multi-institutional collection of clinical information in patients with HD may allow for the identification of additional risk factors for HAEC and afford the opportunity to improve care.

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Section: Discussioncontrasting

confidence: 99%

Comparison of Hirschsprung Disease Characteristics between Those with a History of Postoperative Enterocolitis and Those without: Results from the Pediatric Colorectal and Pelvic Learning Consortium

et al. 2020

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“…Recommendations for long-term follow-up (Table 6) Structured follow-up to adulthood, including transition of care is indicated in HSCR [62][63][64][65][66]. As bowel dysfunction is most common during the first few years after surgery [23], patients should be monitored more closely for the early detection of problems, including defective continence, enterocolitis and late complications.…”

Section: Level Of Evidence III Strength Of Recommendation: Strong Fomentioning

confidence: 99%

ERNICA guidelines for the management of rectosigmoid Hirschsprung’s disease

Kyrklund

Sloots

Blaauw

et al. 2020

Orphanet J Rare Dis

105

102

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Background: Hirschsprung's disease (HSCR) is a serious congenital bowel disorder with a prevalence of 1/5000. Currently, there is a lack of systematically developed guidelines to assist clinical decision-making regarding diagnostics and management. Aims: This guideline aims to cover the diagnostics and management of rectosigmoid HSCR up to adulthood. It aims to describe the preferred approach of ERNICA, the European Reference Network for rare inherited and congenital digestive disorders. Methods: Recommendations within key topics covering the care pathway for rectosigmoid HSCR were developed by an international workgroup of experts from 8 European countries within ERNICA European Reference Network from the disciplines of surgery, medicine, histopathology, microbiology, genetics, and patient organization representatives. Recommendation statements were based on a comprehensive review of the available literature and expert consensus. AGREE II and GRADE approaches were used during development. Evidence levels and levels of agreement are noted. Results: Thirty-three statements within 9 key areas were generated. Most recommendations were based on expert opinion. Conclusion: In rare or low-prevalence diseases such as HSCR, there remains limited availability of high-quality clinical evidence. Consensus-based guidelines for care are presented.

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“…A low weight for age (underweight) is a composite indicator and can reflect both stunting and wasting and therefore difficult to interpret [6]. In this study the above indices showed significant nutritional deficiencies in subjects with colonic stomas.…”

Section: Discussionmentioning

confidence: 63%

“…The results were expressed as Z scores which denoted the number of standard deviations from the mean. Children with scores below -2 standard deviations (< -2 SD) were considered as having nutritional deficits [6]. In all subjects the weights and heights/ lengths were taken by the scale from Measuretek® which was calibrated to an accuracy of 0.01 kgs and 0.1 cm (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

“…Second, the stomas are associated with recurrent trauma to the exposed mucosa and surrounding skin leading to chronic blood loss and anaemia which further worsens the nutrition state [1,4]. Finally, it is likely that the dietary intake of patients with stoma is not adequate due to underlying disease, socio-economic factors or as an attempt to adapt the stomal output to a manageable socially acceptable state [5,6].…”

Section: Introductionmentioning

confidence: 99%

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The nutritional impact of colonic stomas in children. A case control study

Mwika¹,

Osawa²,

Ngung’u³

et al. 2020

Surg Rehabil

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Introduction: Colostomies are fashioned in children for several conditions majority of which are congenital colorectal disorders such as Hirschsprung's disease and Anorectal malformations. Nutritional deficiencies may be seen in children with colostomies as a result of altered gut function, inadequate food intake and chronic anaemia. To mitigate the risk of poor outcome, identification of such nutritional deficits is warranted and this forms the basis of this study whose main objective was to assess the nutritional impact of colostomies in children. Materials and methods:A descriptive case-control study was carried out in Kenyatta National Hospital between 2015 and 2017 where 80 participants in total were recruited. Children with colonic stomas were assigned as cases (n=40) and those without stomas as controls (n=40). Anthropometric indicators were used to assess the nutritional status of the both groups for comparison. Data was analysed and presented based on nutritional Z-scores.Results: Wasting was significantly more prevalent among in the case group (22.5%) than in the control group (5%), OR = 5.52(95% CI 1.11-27.43), P = 0.037. There was no significant difference in the anthropometric measures of stunting and underweight between the cases and controls. Conclusion:On the basis of both anthropometric measures, colostomies are associated with nutrition deficiencies in children. Identification of these deficits through active nutritional screening may mitigate the risk of poor outcome in children with colostomies.

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Impaired growth outcomes in children with congenital colorectal diseases

Abstract: Patients born with CHARM anomalies are at risk for impaired growth. Furthermore study is warranted to identify modifiable risk factors contributing to this impairment. Longitudinal follow-up should include interventions to mitigate these risks.

Cited by 5 publications

References 19 publications

Comparison of Hirschsprung Disease Characteristics between Those with a History of Postoperative Enterocolitis and Those without: Results from the Pediatric Colorectal and Pelvic Learning Consortium

Comparison of Hirschsprung Disease Characteristics between Those with a History of Postoperative Enterocolitis and Those without: Results from the Pediatric Colorectal and Pelvic Learning Consortium

ERNICA guidelines for the management of rectosigmoid Hirschsprung’s disease

The nutritional impact of colonic stomas in children. A case control study

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