scholarly journals Use of biofeedback (BFB) in the treatment of fecal incontinence after surgical correction of anorectal malformations by posterior sagital anorectoplasty (PSARP)

1997 ◽  
Vol 115 (3) ◽  
pp. 1427-1432 ◽  
Author(s):  
José Luiz Martins ◽  
José Pinus
Keyword(s):  
Fecal Incontinence ◽  
Pediatric Surgery ◽  
Outcome Measure ◽  
Anorectal Malformations ◽  
Anatomical Reconstruction ◽  
Physical Exercises ◽  
Anorectal Stenosis ◽  
Surgery Department ◽  
Study Setting ◽  
Primary Psarp

OBJECTIVE: To evaluate biofeedback(BFB)responses to rehabilitation techniques and physical exercises in incontinent or partially continent anorectal malformations patients after posterior sagital anorectoplasty (PSARP). DESIGN: Prospective study. SETTING: Pediatric Surgery - Department of Surgery - UNIFESP-EPM. PATIENTS:The authors report on 14 patients with anorectal malformations (4 with partial fecal incontinence after primary PSARP; 6 with fecal incontinence after primary PSARP; 3 with partial fecal incontinence after secondary PSARP; and 1 with fecal incontinence after secondary PSARP). All patients were rehabilitated via a BFB program of exercises in order to improve the function of the anal sphincteric muscular complex for a period of 1 -3 years. MAIN OUTCOME MEASURE: Clinical and manometric control. RESULTS: After BFB, of 4 partially continent patients after primary PSARP, 3 became continent; of 6 incontinent patients after primary PSARP, 4 became continent; of 3 partially continent patients after secondary PSARP, 1 became continent,1 showed no improvement and 1 became incontinent (infection + abscess + fibrosis + important anorectal stenosis). The incontinent patient after secondary PSARP showed no improvement. CONCLUSION: The authors concluded that BFB, used at the appropriate time with patient collaboration, is an important complement to the anatomical reconstruction of anorectal malformations in order to achieve good development and contractile functioning of the sphincteric muscular complex.

scholarly journals 70th ANNIVERSARY OF THE DEPARTMENT OF PEDIATRCI SURGERY OF N. N. BURDENKO VORONEZH STATE MEDICAL UNIVERISTY

2019 ◽  
Vol 8 (4) ◽  
pp. 97-104
Author(s):  
V. A. Vecherkin ◽  
S. N. Gisak ◽  
V. A. Ptitsyn ◽  
N. V. Glagolev ◽  
D. A. Baranov ◽  
...  
Keyword(s):  
Pediatric Surgery ◽  
Research Work ◽  
Gold Medal ◽  
Practical Work ◽  
70Th Anniversary ◽  
History Of ◽  
Surgery Department ◽  
Medical University

The article considers the history of the pediatric surgery department of N. N. Burdenko Voronezh State Medical University. The department was founded in 1947. Based on the results of the research undertaken by associates of the department by now, 3 manuals for doctors and students and 12 collections of scientifc papers were issued and 12 investor’s certifcates were obtained. The role of the Student’s scientifc circle was noted: the students struck 5 gold medals during the last fve years. During the last 8 years, the scientifc circle was considered the best and was awarded a gold medal and frstclass honours degree. A close interrelation between the research work of associates of the pediatric surgery department and practical work of pediatric surgeons from the Central Black Earth region was underlined.

scholarly journals Currarino Syndrome (SC): A case at the University Hospital of Mother and Child Lagune Cotonou

2021 ◽  
Vol 4 (2) ◽  
pp. 01-03
Author(s):  
Gbenou A.S
Keyword(s):  
Anorectal Malformations ◽  
University Hospital ◽  
X Ray ◽  
Currarino Syndrome ◽  
Abdominal Approach ◽  
Operative Specimen ◽  
Mother And Child ◽  
Posterior Sagittal Approach ◽  
Surgery Department ◽  
The University

Introduction: The Currarino syndrome (CS) is one of the rare syndromic forms of anorectal malformations (ARM). Observation: This is the clinical case of a 3 days male newborn admitted for high ARM in the pediatric surgery Department of the Lagune Mother and Child University Hospital of Cotonou. An emergency colostomy was performed. At the age of 7 months as a prelude to anorectoplasty, the distal colography revealed a semilunar pelvic opacity in front of the sacrum. The posterior sagittal approach according to Peña could not reveal the distal end of the intestine. The reconstruction of the sphincter-muscular complex was done on a tracheal tube. The abdominal approach allowed the discovery and resection of a presacral mass. The rectal pouch end found was then lowered. Post-operative follows up was uneventful. The standard postoperative X-ray revealed a partial agenesis of the sacrum. The histology of the operative specimen found a cystic lipoma. The diagnosis of CS was done. The search of a HLXB9 mutation was not possible. Conclusion: The clinical observation associated with standard radiological investigations highlighted the triad: anorectal malformation, presacral tumor, and partial agenesis of the sacrum, which upheld the diagnosis of CS; but the search for an indispensable HLXB9 mutation was lacking for the genetic link.

scholarly journals A Proactive Risk Assessment Through Healthcare Failure Mode and Effect Analysis in Pediatric Surgery Department

2020 ◽  
Vol 11 (3) ◽  
Author(s):  
Yasamin Molavi-Taleghani ◽  
Hossein Ebrahimpour ◽  
Hojjat Sheikhbardsiri
Keyword(s):  
Risk Assessment ◽  
Failure Mode ◽  
Pediatric Surgery ◽  
Failure Modes ◽  
Cross Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Effect Analysis ◽  
Acceptable Risks ◽  
Surgery Department

Background: Patient safety is the first step to improve the quality of care. Objectives: Therefore, the present study aimed to examine the risk assessment of processes in a pediatric surgery department using the Health Failure Mode and Effect Analysis (HFMEA) in 2017 - 2018. Methods: In this research, a mixed-method design (qualitative action and quantitative descriptive cross-sectional study) was used to analyze failure mode and their effects. The nursing errors in the clinical management model were used to classify failure modes, and the theory of inventive problem solving was used to determine a solution for improvement. Results: According to the five procedures selected by the voting method and their rating, 25 processes, 48 sub-processes, and 218 failure modes were identified with HEMEA. Eight risk modes (3.6%) were found as non-acceptable risks and were transferred to the decision tree. The main root causes (hazard score ≥ 4) were as follows: Technical-related factors (14.34%), organizational-related factors (31.9%), human-related factors (45.3%), and other factors (7.6%). Conclusions: The HFMEA method is very effective in identifying the possible failure of treatment procedures, determining the cause of each failure mode, and proposing improvement strategies.

Long-Term Outcome after Dynamic Graciloplasty for Treatment of Persistent Fecal Incontinence in Patients with Anorectal Malformations

2018 ◽  
Vol 29 (03) ◽  
pp. 276-281
Author(s):  
Johan Danielson ◽  
Urban Karlbom ◽  
Tomas Wester ◽  
Wilhelm Graf
Keyword(s):  
Quality Of Life ◽  
Fecal Incontinence ◽  
Short Form ◽  
Anorectal Malformations ◽  
Dynamic Graciloplasty ◽  
Term Outcome ◽  
Long Term Outcome

Purpose Dynamic graciloplasty (DGP) has been used to treat severe fecal incontinence since the 1980s. Previous studies have shown an inferior outcome in patients with anorectal malformations (ARMs). Our experience has been that DGP has been appreciated by ARM -patients. The objective of the study was to evaluate the long-term outcome of DGP in our patients with ARM compared with patients with other underlying conditions. Materials and Methods Twenty-three patients operated with DGP at our institution from 1996 to 2010 were sent validated bowel function and quality of life questionnaires. Eighteen of 23 responded. Seven had ARM and 11 had other etiologies of fecal incontinence. The mean follow-up time was 11.6 years (range, 5–17). Results Four of 7 of the patients with ARM and 8 of 11 of patients with other etiologies used their implants at follow-up. The Miller incontinence score was slightly higher for patients with ARMs, but they had less constipation and higher Fecal Incontinence Quality of Life (FIQL)- and 36-Item Short Form Health Survey (SF-36) scores. None of the differences were statistically significant. Conclusion This study cannot confirm earlier reports in which DGP has an inferior outcome in patients with ARM. We therefore believe that the procedure should remain a treatment option for selected patients.

scholarly journals Comparison of frequency of complications in loop versus divided colostomy in patients with high variety anorectal malformation

2020 ◽  
Vol 9 ◽  
pp. 4
Author(s):  
Masood Shah ◽  
Nabi Bux Napar ◽  
Faryal Ilyas Jhammat ◽  
Hafiza Shehla Arshad ◽  
Mohammed Saleem
Keyword(s):  
Anorectal Malformation ◽  
Parastomal Hernia ◽  
Anorectal Malformations ◽  
Operational Definition ◽  
P Value ◽  
Group A ◽  
Group B ◽  
Surgery Department ◽  
Stoma Prolapse ◽  
Sigmoid Colostomy

Background: The objective of this study was to compare frequency of stoma related complications of loop versus divided sigmoid colostomy for the management of high variety anorectal malformations. Methodology: This RCT was conducted in the department of Pediatrics Surgery Department of the Children’s Hospital and the Institute of Child Health Lahore, for the period of one year from 1st May 2016 to 1st June 2017. One hundred and twenty patients (Sixty patients in each group) of anorectal malformation meeting inclusion criteria were taken in this study. Patients were divided into two groups randomly using lottery method; loop sigmoid colostomy in Group-A and divided sigmoid colostomy in Group-B. After surgeries patients were followed weekly up till 8 weeks. Stoma related complications (as per operational definition) were noted. Results: The mean age in group –A and group-B were 3.34 ± 1.12 days and 3.36 ± 0.97 days, respectively. In group – A there were 52(86.67%) male and 8(13.33%) females, and in group-B there were 45(75%) male and 15(25%) female patients. In group-A 22(36.66%) patients had complications [3(5.00%) patients had retraction, 8(13.33%) had prolapse, 4(6.67%) had stoma obstruction, parastomal hernia were seen in 4(6.67%), stoma necrosis were seen in 3 (5.00%)] and in group-B, 16(26.66%) patients had different complications [1(1.67%) patients had retraction, 3(5.00%) had prolapse, 5(8.33%) had stoma obstruction, parastomal hernia were seen in 2(3.3%), stoma necrosis were seen 5(8.33%)]. The complications in group-A were higher when compared to group-B, but (p-value = 0.650) were not significant statistically except for stoma prolapse. Conclusion: Though complication rate in both techniques is not statistically different but frequency of stoma prolapse is more in loop colostomy group. Therefore, divide colostomy should be opted as preferred technique.

scholarly journals Duplication and Multiseptate Urinary Bladder: A Rare Case Report

2021 ◽  
Vol 57 (3) ◽  
pp. 267
Author(s):  
Muhammad Fawzi Zulfikar ◽  
Wahjoe Djatisoesanto ◽  
Tarmono Tarmono
Keyword(s):  
Magnetic Resonance Imaging ◽  
Pediatric Surgery ◽  
Rare Case ◽  
Congenital Abnormalities ◽  
Urinary Tract Obstruction ◽  
Resonance Imaging ◽  
Rare Case Report ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Surgery Department

The multiseptate bladder is a congenital bladder anomaly that is very rare and often accompanied by other congenital abnormalities. This condition could result in intravesical obstruction and kidney failure in more serious conditions. A 3-year-old girl without any complaint was consulted by the Pediatric Surgery Department with postoperative cloacal type malformation anorectal (MAR) postero-sagittal anorecto-vagino-urethroplasty (PSARVUP) + sigmoidectomy. Magnetic Resonance Imaging (MRI) of the pelvis showed the appearance of four interconnected multiple fluid lesions. Cystoscopy was performed and found many septa with varied positions and forms. From the cystography during the operation, it was seen duplication of the right and left bladder. There was no further operative treatment in the field of urology because no urinary tract obstruction and normal renal function were found in this study.

Framework for crisis preparedness planning: Four required areas for developing a learning process

2016 ◽  
Vol 13 (6) ◽  
pp. 519
Author(s):  
Kerstin Eriksson, PhD
Keyword(s):  
Crisis Management ◽  
Learning Process ◽  
Planning Process ◽  
Outcome Measure ◽  
Research Literature ◽  
Crisis Preparedness ◽  
Local Authorities ◽  
Preparedness Planning ◽  
Study Setting ◽  
Management Work

Objective: To outline a framework for preparedness planning at the organizational level.Design: The study is based on a content analysis of research literature as well as an analysis of interviews with six preparedness planners working in Swedish local authorities.Setting: The study setting included Swedish local authorities of different sizes.Subjects, participants: The participants are preparedness planners responsible for coordinating crisis management work in Swedish local authorities. The study includes preparedness planners with different backgrounds, education, experiences, and gender.Interventions: A presentation of 19 factors of preparedness planning identified in the literature and a discussion around how preparedness planners perceive those factors.Main outcome measure(s): The main outcome measures are knowledge about how both researcher and practitioner understand and argue around different factors of preparedness planning.Results: The result of this study is a framework for preparedness planning. As preparedness planning ought to be a learning process, the presented framework builds on four areas connected to learning: prerequisites for preparedness planning, who should be involved, what is to be learned, and how should the work be shaped.Conclusions: The analysis of factors identified in the literature and also in the interviews with preparedness planners illustrates that the four areas connected to learning are required for developing a preparedness planning process.

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