Error Traps and Culture of Safety in Anorectal Malformations

The June issue of Seminars and Pediatric Surgery focused on a topic that's important to every pediatric surgeon, improving the healthcare we deliver to children around the world. Follow along with our latest video series as we highlight articles that help enhance the culture of safety in various pediatric surgical subspecialties. And you might recognize a few well-known faces and names along the way. Here's a quick summary of Error Traps and Culture of Safety in Anorectal Malformations, with guest video reviewer Dr. Andrea Bischoff. We have identified five error traps. The first one is the creation of a colostomy too distal in the sigmoid colon. Our recommendation is for a colostomy at the descending colon. The second error trap is having an inaccurate distal colostogram. A correctly done distal colostogram should show the site of the mucus fistula, the amount of bowel length available for the poo through. The end of the rectum or the connection to the urinary tract, whenever possible, the bladder and the urethra, the tip of the sacrum and the anal marker. The third error trap is operating on a male patient without a foley catheter and ignoring the hazards of the separation between the anterior rectal wall and the genitourinary tract. The fourth error tract is attempting to dilate a true rectal stricture. Anal dilations are not for real strictures. And the fifth error trap is not offering long-term follow-up to these patients. Those patients need long-term follow-up in colorectal, urology, and gynecology. We believe that by avoiding these common error traps, patients will receive better care.