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Video Published 2026-06-09

Timestops (4)

Do we have a safe way to reduce repeat procedures for patien…

Do we have a safe way to reduce repeat procedures for patients with post-operative stricture after surgery for an anorec…

We studied our institution's experience in this procedure fr…

We studied our institution's experience in this procedure from 2018 to 2024 and asked whether adding tac to dilations wa…

The median number of injections needed to achieve stricture …

The median number of injections needed to achieve stricture resolution was just 1 in both groups. There were still some …

For patients with post-operative strictures who have anal re…

For patients with post-operative strictures who have anal rectum malformations or Hirschpring disease, TA injections may…

Topic Overview

A single-speaker presentation of a 2026 retrospective study from Nationwide Children's Hospital examining triamcinolone acetonide (TAC) injections as adjunct therapy for post-operative anastomotic strictures in pediatric patients with anorectal malformations and Hirschsprung disease. The study of 50 patients (2018-2024) found stricture resolution in 70% of ARM patients and 85% of Hirschsprung patients, with a median of one injection needed and a 2.2% 30-day complication rate. The presenter frames TAC injection as a potentially safe, minimally invasive option before surgical revision, though notes the single-center retrospective design as a limitation.

Key Takeaways

TAC injection resolved strictures in 70% of ARM and 85% of Hirschsprung patients, median 1 injection needed. (0:46)
30-day complication rate was 2.2% with no intraoperative complications from TAC injections. (1:06)
30% of ARM and 10% of Hirschsprung patients still required surgery despite TAC treatment. (1:00)
TAC may offer minimally invasive option before surgical revision for post-op anastomotic strictures. (1:14)

Inside this episode

Kai, the Library's AI content creator, listened to this episode and mapped who's speaking, the chapters, key claims, and cases. Every item links to the exact moment in the recording.

AI-enriched

Who's speaking

Megan Reed Evaurri — guest

Chapters

0:00Introduction and Study Design — Speaker introduces herself and the 2026 retrospective study examining triamcinolone acetonide injections after dilation for post-operative strictures in ARM and Hirschsprung patients, covering 2018-2024 institutional experience.
0:38Study Results — Presentation of findings from 50 patients: stricture resolution rates, median injection numbers, surgical revision rates, and safety outcomes including complication rates.
1:06Clinical Implications — Summary of TAC injections as a safe, minimally invasive adjunct with promising resolution rates, acknowledging study limitations and positioning it as a treatment option before surgical revision.

Key claims

0:15The study was published in 2026 in the Journal of Pediatric Surgery — Megan Reed Evaurri
0:28The study examined institutional experience from 2018 to 2024 — Megan Reed Evaurri
0:4050 patients developed post-operative anastomotic stricture: 30 with anorectal malformations and 20 with Hirschsprung disease — Megan Reed Evaurri
0:4670% of patients with anorectal malformations achieved stricture resolution with TAC injections — Megan Reed Evaurri
0:5085% of patients with Hirschsprung disease achieved stricture resolution with TAC injections — Megan Reed Evaurri
0:55The median number of TAC injections needed to achieve stricture resolution was 1 in both groups — Megan Reed Evaurri
1:0030% of anorectal malformation patients required surgery despite TAC injections — Megan Reed Evaurri
1:0010% of Hirschsprung disease patients required surgery despite TAC injections — Megan Reed Evaurri
1:06There were no intraoperative complications from TAC injections — Megan Reed Evaurri
1:06The 30-day complication rate was 2.2% — Megan Reed Evaurri
1:14TAC injections may be a safe, minimally invasive adjunct to traditional dilations with promising rates of stricture resolution and low short-term morbidity — Megan Reed Evaurri
1:27This is a retrospective single center study — Megan Reed Evaurri
1:27TAC injections may be a useful treatment option before moving on to another operation — Megan Reed Evaurri

Open questions

Would TAC injection protocols change stricture management practices at other institutions?

This episode was analyzed and enriched by Kai, the Library's AI content creator. Every item links to the moment it comes from — click a timestamp to listen in context.

Keywords

anorectal malformations Hirschsprung disease post-operative anastomotic stricture triamcinolone acetonide injection dilation surgical revision triamcinolone acetonide Nationwide Children's Hospital Center for Colorectal and Pelvic Reconstruction

Transcript

Do we have a safe way to reduce repeat procedures for patients with post-operative stricture after surgery for an anorectal malformation or Hirschprung disease? My name is Megan Reed Evaurri. I'm with the Center for Colorectal and Pelvic Reconstruction at Nationwide Children's Hospital, and this is an article you should know about. In 2026, we published a retrospective study in the Journal of Pediatric Surgery looking at the use of triamcinolone acetonide injections or TAC after dilation for postoperative. Systematic stricture for patients with anorectal malformations and Hirschprung disease. We studied our institution's experience in this procedure from 2018 to 2024 and asked whether adding tac to dilations was safe and whether it helped achieve stricture resolution. So, what did we find? We looked at 50 patients who developed post-operative anastomotic stricture, 30 with interectum affirmations and 20 with Hirschprug disease. We found that 70% of patients with innerectum affirmation. And 85% of patients with Hirschprung disease achieved stricture resolution with TA injections. The median number of injections needed to achieve stricture resolution was just 1 in both groups. There were still some patients who required surgery, 30% in the inter rectum malformation group and 10% in the Hirschsprung disease group. However, there were no intraoperative complications from the TA injections and the 30-day complication rate was 2.2%. So what's the takeaway? For patients with post-operative strictures who have anal rectum malformations or Hirschpring disease, TA injections may be a safe, minimally invasive adjunct to traditional dilations with promising rates of stricture resolution and low short-term morbidity. This is a retrospective single center study, but it suggests that these injections may be a useful treatment option before moving on to doing another operation. So, would this change the way that you manage post-operative recurrent anastomotic strictures at your institution?

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