CINCINNATI--(EON: Enhanced Online News)--A lot has changed in the world since 1980, but few things more profoundly, perhaps, than the quality of life that can be achieved for children born with imperforate anus and other bowel-related conditions that require complex surgical repair.
“As a consequence, the functional results of the repairs were very bad in terms of bowel control, and we frequently provoked additional damage to important anatomic structures such as the bladder, the urethra and nerves that provide urinary and sexual function.”
Thirty years ago this week, Alberto Peña, M.D., director of the Colorectal Center for Children at Cincinnati Children’s Hospital Medical Center, decided he was no longer satisfied with the available techniques used to repair congenital anorectal malformations and, for the first time, he performed the posterior sagittal anorectoplasty (PSARP) or the “Peña pull through procedure.”
“Prior to 1980, the available techniques used to repair anorectal malformations were mostly blind. We were unable to see the intrinsic anatomic features of the defect,” says Dr. Peña. “As a consequence, the functional results of the repairs were very bad in terms of bowel control, and we frequently provoked additional damage to important anatomic structures such as the bladder, the urethra and nerves that provide urinary and sexual function.”
With the PSARP, Dr. Peña was able to identify the anatomy of the malformations and design a way to repair it without inflicting further damage to important neighboring structures.
“We can now correlate the internal anatomy with the functional results. This translates into better quality of life for many children born with anorectal malformations,” says Dr. Peña.
Since the PSARP was first performed, Dr. Peña and Marc A. Levitt, M.D., associate director of the Colorectal Center for Children, have treated surgically 2,567 patients using the PSARP or a variation thereof. The center is the world’s only one focused on the comprehensive and multidisciplinary care of children with colorectal problems.
“When Dr. Peña performed the PSARP for the first time in 1980 it was considered ‘surgical heresy’,” says Dr. Levitt. “It has now become the operation utilized throughout the world.”
Over the past 30 years Dr. Peña has placed particular emphasis on teaching his colleagues about the operation and how to improve the functional outcome of patients. “He is never satisfied with only a perfect anatomic reconstruction but works tirelessly to achieve a good functional result,” says Dr. Levitt.
Drs. Peña and Levitt devote time to training other surgeons to perform the PSARP, both in the United States and around the world. Twice a year, international surgeons gather in Cincinnati to attend a three-day course, including operative demonstrations, hosted by the Colorectal Center for Children and Cincinnati Children’s. Additionally, both doctors travel the world teaching and performing the PSARP. Dr. Peña has visited in excess of 30 countries over his career, effectively improving child health in each of those countries by training their surgeons to treat children with colorectal conditions. Collectively, Drs. Peña and Levitt have cared for children from 80 countries and from all 50 states.
About Cincinnati Children’s
Cincinnati Children’s Hospital Medical Center is one of just eight children’s hospitals named to the Honor Roll in U.S. News and World Report’s 2010-11 Best Children’s Hospitals. It is ranked #1 for digestive disorders and highly ranked for its expertise in pulmonology, cancer, neonatology, heart and heart surgery, neurology and neurosurgery, diabetes and endocrinology, orthopedics, kidney disorders and urology. Cincinnati Children’s is one of the top two recipients of pediatric research grants from the National Institutes of Health. It is internationally recognized for quality and transformation work by Leapfrog, The Joint Commission, the Institute for Healthcare Improvement, the federal Agency for Healthcare Research and Quality, and by hospitals and health organizations it works with globally. Additional information can be found at www.cincinnatichildrens.org.