Emanuele Ausili1,2, A Marte3, G Brisighelli4, P Midrio5, G Mosiello6, E La Pergola5, L Lombardi7, B D Iacobelli6, E Caponcelli8, M Meroni8, E Leva4, C Rendeli9. 1. Spina Bifida Center, Department of Science of the Health of Women and Children, Catholic University Medical School, Rome, Italy. emanuele.ausili@tin.it. 2. Spina Bifida Center-Pediatric Department, Catholic University of Sacred Heart, Largo Gemelli 8, 00168, Rome, Italy. emanuele.ausili@tin.it. 3. Pediatric Surgery Unit, Università della Campania Luigi Vanvitelli, Naples, Italy. 4. Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy. 5. Mother and Child Department, Cà Foncello Regional Hospital, Treviso, Italy. 6. Neuro-Urology Unit/Spina Bifida Center and Department of Medical and Surgical Neonatology, Bambino Gesù Children Hospital and Research Institute, Rome, Italy. 7. Pediatric Surgery Unit, Pediatric Hospital, Parma, Italy. 8. Pediatric Surgery Unit, Vittore Buzzi Pediatric Hospital, Milan, Italy. 9. Spina Bifida Center, Department of Science of the Health of Women and Children, Catholic University Medical School, Rome, Italy.
Abstract
PURPOSE: We assessed short- and mid-long-term clinical efficacy of transanal irrigation (TAI) and its effect on the quality of life of children with spina bifida (SB) and anorectal malformations (ARM). METHODS: Seventy-four pediatric patients (age 6-17 years) with SB and ARM with neurogenic bowel dysfunction were enrolled for a prospective and multicentric study. Patients were evaluated before the beginning of TAI (T0), after 3 months (T1) and after at least 2 years (range 24-32 months) (T2) using a questionnaire assessing bowel function, the Bristol scale, and two validated questionnaires on quality of life: the CHQ-PF50 questionnaire for the parents of patients aged 6-11 years and the SF36 questionnaires for patients aged between 12 and 18 years. RESULTS: Seventy-two patients completed TAI program in T1, and 67 continued into T2. Bowel outcomes (constipation and fecal incontinence) improved in both the SB and the ARM groups in the short and mid-long term. In both groups at T1 and T2, parents and children reported an improvement in quality of life and there was a significant increase of stool form types 4 and 5 as described by the Bristol scale. Common adverse effects during the study were similar at T1 and T2 without serious complications. CONCLUSIONS: We observed a sustained improvement in bowel management and quality of life in SB and ARM children during the study, more significant in the short term than in mid-long term. To maintain success rates in the mid-long term and to reduce the dropout rate, we propose patient training and careful follow-ups.
PURPOSE: We assessed short- and mid-long-term clinical efficacy of transanal irrigation (TAI) and its effect on the quality of life of children with spina bifida (SB) and anorectal malformations (ARM). METHODS: Seventy-four pediatric patients (age 6-17 years) with SB and ARM with neurogenic bowel dysfunction were enrolled for a prospective and multicentric study. Patients were evaluated before the beginning of TAI (T0), after 3 months (T1) and after at least 2 years (range 24-32 months) (T2) using a questionnaire assessing bowel function, the Bristol scale, and two validated questionnaires on quality of life: the CHQ-PF50 questionnaire for the parents of patients aged 6-11 years and the SF36 questionnaires for patients aged between 12 and 18 years. RESULTS: Seventy-two patients completed TAI program in T1, and 67 continued into T2. Bowel outcomes (constipation and fecal incontinence) improved in both the SB and the ARM groups in the short and mid-long term. In both groups at T1 and T2, parents and children reported an improvement in quality of life and there was a significant increase of stool form types 4 and 5 as described by the Bristol scale. Common adverse effects during the study were similar at T1 and T2 without serious complications. CONCLUSIONS: We observed a sustained improvement in bowel management and quality of life in SB and ARM children during the study, more significant in the short term than in mid-long term. To maintain success rates in the mid-long term and to reduce the dropout rate, we propose patient training and careful follow-ups.
Authors: M P Gosselink; M Darby; D D E Zimmerman; A A A Smits; I van Kessel; W C Hop; J W Briel; W R Schouten Journal: Colorectal Dis Date: 2005-01 Impact factor: 3.788
Authors: C Rendeli; E Ausili; F Tabacco; B Focarelli; A Pantanella; C Di Rocco; O Genovese; C Fundarò Journal: Aliment Pharmacol Ther Date: 2006-04-15 Impact factor: 8.171
Authors: Anna Maria Caruso; Mario Pietro Marcello Milazzo; Denisia Bommarito; Vincenza Girgenti; Glenda Amato; Giuseppe Paviglianiti; Alessandra Casuccio; Pieralba Catalano; Marcello Cimador; Maria Rita Di Pace Journal: Children (Basel) Date: 2021-12-11