AUTHOR=Vilanova-Sánchez Alejandra , Reck Carlos Albert , Wood Richard J. , Garcia Mauriño Cristina , Gasior Alessandra C. , Dyckes Robert E. , McCracken Katherine , Weaver Laura , Halleran Devin R. , Diefenbach Karen , Minzler Dennis , Rentea Rebecca M. , Ching Christina B. , Jayanthi Venkata Rama , Fuchs Molly , Dajusta Daniel , Hewitt Geri D. , Levitt Marc A.
TITLE=Impact on Patient Care of a Multidisciplinary Center Specializing in Colorectal and Pelvic Reconstruction
JOURNAL=Frontiers in Surgery
VOLUME=5
YEAR=2018
URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2018.00068
DOI=10.3389/fsurg.2018.00068
ISSN=2296-875X
ABSTRACT=Aim of the study: Many patients with an anorectal malformation (ARM) or pelvic anomaly have associated urologic or gynecologic problems. We hypothesized that our multidisciplinary center, which integrates pediatric colorectal, urologic, gynecologic and GI motility services, could impact a patient's anesthetic exposures and hospital visits.
Methods: We tabulated during 2015 anesthetic/surgical events, endotracheal intubations, and clinic/hospital visits for all patients having a combined procedure.
Main results: Eighty two patients underwent 132 combined procedures (Table 1). The median age at intervention was 3 years [0.2-17], and length of follow up was 25 months [7-31]. The number of procedures in patients who underwent combined surgery was lower as compared to if they had been done independently [1(1-5) vs. 3(2-7) (p < 0.001)]. Intubations were also lower [1[1-3] vs. 2[1-6]; p < 0.001]. Hospital length of stay was significantly lower for the combined procedures vs. the theoretical individual procedures [8 days [3-20] vs. 10 days [4-16]] p < 0.05. Post-operative clinic visits were fewer when combined visits were coordinated as compared to the theoretical individual clinic visits (urology, gynecology, and colorectal) [1[1-4] vs. 2[1-6]; p = < 0.001].
Conclusions: Patients with anorectal and pelvic malformations are likely to have many medical or surgical interventions during their lifetime. A multidisciplinary approach can reduce surgical interventions, anesthetic procedures, endotracheal intubations, and hospital/outpatient visits.