Toshio Harumatsu, MD, PhD - Best of the Best in Pediatric Surgery 2024

All right, moving on to our second presentation by Doctor Toshio Haramatsu, a pediatric surgeon from the Department of Pediatric Surgery in Kagoshima University from Japan, also representing WOFAs with an analysis of the potential risk factors for defecation problems and their bowel management based on long-term bowel function in patients with the persistent cloaca, which are results from a nationwide survey in Japan. Excited to see it. Hello, everyone. I'm Toshio Hamat from Kagoshima, Japan. Today, I'd like to talk about the potential risk factors for defecation problems in patients with persistent crore. I have nothing to disclose. The aim of this study is to clarify the potential risk factors for defecation programs in patients with PC. This slide shows the materials and methods of this study. Patient information was obtained by sending a questionnaire and a total of 213 PC patients who responded to the questionnaire were re-enrolled. Our primary outcome was to investigate potential risk factors associated with defecation problems in PC patients. Potential risk factors. To clarify the potential risk factors fordation problems in patients with PC, we investigated the associated anomalies, the timing of neurecttoplasty, and aneurecttoplasty procedures. Current status of Bower management. The relationship between defecation problems and the current status of power management was also evaluated. Clinical characteristics. The clinical characteristics of the patient with defecation problems and patient without defecation problems are shown in this table. The age at replasty of patients with defecation problems was significantly younger in comparison to patients without problems. And no significant differences were observed between the two groups, the other parameters. Logistic regulation analysis of potential risk factors. This slide showed a logistic regulation analysis to clarify the relationship between defecation problems and potential risk factors for bowel dysfunction. A multi-variable logistic analysis shows that the associated anomaly of sacral agenesis independently increase the risk of defecation problems. Logistic regulation analysis of power management. This table showed a multi variable logistic regression analysis of factors associated with power management in PC patients with defecation problems. This analysis further clarified that PC patients who underwent the oral administration of laxatives and anti-grade continence enema independently had the defecation problems. Discussion. Sacral agenesis. Sacral agenesis have been reported as anomalies associated with the bowel function. And in cases we imperforate NS, bowel management was less effective. In a study, 24% of PC patients had sacral agenesis, and a much variable logistic analysis shows that sacral agenesis was significantly associated with suffering defecation problems. The same could be expected to be true for PC patients. Here are conclusions. Thank you for your attention. All right. Cecilia, do you have a question? thank you for the study. Um, I think it's, I, I guess what I'm wondering is, you know, we're starting to think that the causative factor may be sacral agenesis in these PC patients. Um, but I don't know if that, have you thought of a clinical, uh, um, scenario where this would help us, this understanding of knowing this, how can this help us mitigate or decrease the defecation problems in these patients? What Uh, uh, I'm, I'm sorry, um, um, yeah, so, um. Is there something that we can do? To make this better. Uh, in patients with sacral agenesis, is there something we can do to help them? Yes, uh, thank you for your question. Mm, it's a very difficult problem. Uh, so, uh, mm. We, we can do, uh, Uh, regularly took laxatives and, uh, uh, regularly enema is a, uh, Good way to get a good bowel function. OK. So, so it's more about awareness for the clinician to be able to anticipate that they'll have a problem. Um, I think this was a great paper. I appreciate you, uh, you presenting this here. Uh, very good paper. Thank you so much and congratulations. Thank you for your comment. Thank you. Awesome.