Quality outcomes for pediatric colorectal surgery treated during short-term international medical service trips at a dedicated site in Honduras

• Published in: Journal of pediatric surgery 2021-04, Vol.56 (4), p.805-810
• Main Authors: Krois, Wilfried, Rentea, Rebecca M., Hernandez, Pastora X., Craniotis-Rios, Juan, Wood, Richard J., Levitt, Marc A., Reck-Burneo, Carlos A.
• Format: Article
• Language: English
• Subjects: Anorectal malformation; Cloaca; Follow-up; Hirschsprung disease; Pediatric colorectal surgery; Short-term international medical service trips
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2020.06.040

Short-term international medical service trips (MSTs) provide specialized care in resource-constrained countries. There are limited data on immediate and long-term reported outcomes following specialty MST. We hypothesized that dedicated collaborative MST team and host institution produce outcomes and results comparable to those of high-income settings. Our primary aim was to analyze the long-term surgical and functional outcomes of our specialty-specific MSTs following five years of annual MST in Honduras. We performed a single-institution retrospective analysis of 56 children who underwent colorectal and pelvic reconstructive operations between 2014 and 2018. Demographics, diagnosis, comorbidities, type of repair, long-term complications, and functional bowel and bladder results were recorded. We included a total of 56 children, 47 with ARM and 9 with HD, with a median age of 43.5 months (17–355) at the time of surgery. 25% (22) of the patients were lost to follow-up. Fecal continence was achieved by 23 (60%) patients 5 years (n = 11). Complications included constipation in 18 (42.9%) children with ARM and in 1 (12.5%) with HD. Eleven (19.6%) patients required revisional surgery for skin level anal stricture. Seventy-five percent of the patients with pediatric colorectal disorders attending the MST were compliant with continued long-term follow-up. We were able to demonstrate that with organized, dedicated site and surgeon, results achieved can be comparable to those in the high-income countries (HICs). We conclude that this type of specialized care is feasible and beneficial for affected pediatric colorectal patients in resource-limited settings, when a strong partnership with a system of preoperative assessments and peri- and postoperative care can be established. Level IV (retrospective cohort study).