Characterizing the use of botulinum toxin in patients with Hirschsprung disease treated at referral institutions for pediatric colorectal surgery
Botulinum toxin (BT) is used to treat pediatric patients with Hirschsprung disease (HD) with obstructive symptoms. We aimed to characterize use of BT in HD patients across pediatric colorectal surgery referral centers. A multicenter retrospective study of BT use in children (0–18y) with HD was perfo...
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| Veröffentlicht in: | Journal of pediatric surgery 2022-06, Vol.57 (6), p.1033-1039 |
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| container_title | Journal of pediatric surgery |
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| creator | Rice-Townsend, Samuel E. Nicassio, Lauren Glazer, Debra Avansino, Jeffrey Durham, Megan M. Calkins, Casey M. Rentea, Rebecca M. Ralls, Matthew W. Wood, Richard J. Rollins, Michael D. Garvey, Erin M. Lewis, Katelyn E. Reeder, Ron Smith, Caitlin A. |
| description | Botulinum toxin (BT) is used to treat pediatric patients with Hirschsprung disease (HD) with obstructive symptoms. We aimed to characterize use of BT in HD patients across pediatric colorectal surgery referral centers.
A multicenter retrospective study of BT use in children (0–18y) with HD was performed using the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) between 2017 and 2021. Sites with |
| doi_str_mv | 10.1016/j.jpedsurg.2022.02.005 |
| format | Article |
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A multicenter retrospective study of BT use in children (0–18y) with HD was performed using the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) between 2017 and 2021. Sites with <10 HD patients recorded were excluded. Patterns were evaluated using Fisher's exact, Wilcoxon rank-sum, Kruskal-Wallis, and Cochran-Armitage trend test.
494 patients at 8 centers were included. 118 (23.9%) received at least one BT injection. Among patients who required redo pullthrough procedures, 53.1% received BT compared to 22.7% of patients who only underwent one pullthrough (p<0.001). Age at pullthrough was also significantly associated (p = 0.021). A lower proportion of Hispanic patients received BT (9.6% vs. 26.3%;p = 0.006). Percentage of HD patients receiving BT varied significantly across sites (p<0.001).
Use of BT in patients with HD varies widely with greater use in patients who underwent redo surgery and in those who underwent pullthrough at an older age. Hispanic patients received less BT. These findings highlight the need to develop consensus guidelines and for further study on timing of injections and potential disparities in care.
III</description><identifier>ISSN: 0022-3468</identifier><identifier>EISSN: 1531-5037</identifier><identifier>DOI: 10.1016/j.jpedsurg.2022.02.005</identifier><identifier>PMID: 35292167</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Botox ; Botulinum toxin ; Botulinum Toxins ; Botulinum Toxins, Type A - therapeutic use ; Child ; Colorectal Surgery ; Constipation ; Endorectal pullthrough ; Hirschsprung disease ; Hirschsprung Disease - surgery ; Humans ; Referral and Consultation ; Retrospective Studies ; Treatment Outcome</subject><ispartof>Journal of pediatric surgery, 2022-06, Vol.57 (6), p.1033-1039</ispartof><rights>2022 Elsevier Inc.</rights><rights>Copyright © 2022 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c368t-dcf732bd85999b70f249cc502ca6a397a5acfc1fc9e9bc25765e3fddbae7a1313</citedby><cites>FETCH-LOGICAL-c368t-dcf732bd85999b70f249cc502ca6a397a5acfc1fc9e9bc25765e3fddbae7a1313</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022346822001439$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35292167$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rice-Townsend, Samuel E.</creatorcontrib><creatorcontrib>Nicassio, Lauren</creatorcontrib><creatorcontrib>Glazer, Debra</creatorcontrib><creatorcontrib>Avansino, Jeffrey</creatorcontrib><creatorcontrib>Durham, Megan M.</creatorcontrib><creatorcontrib>Calkins, Casey M.</creatorcontrib><creatorcontrib>Rentea, Rebecca M.</creatorcontrib><creatorcontrib>Ralls, Matthew W.</creatorcontrib><creatorcontrib>Wood, Richard J.</creatorcontrib><creatorcontrib>Rollins, Michael D.</creatorcontrib><creatorcontrib>Garvey, Erin M.</creatorcontrib><creatorcontrib>Lewis, Katelyn E.</creatorcontrib><creatorcontrib>Reeder, Ron</creatorcontrib><creatorcontrib>Smith, Caitlin A.</creatorcontrib><creatorcontrib>Pediatric Colorectal and Pelvic Learning Consortium (PCPLC)</creatorcontrib><title>Characterizing the use of botulinum toxin in patients with Hirschsprung disease treated at referral institutions for pediatric colorectal surgery</title><title>Journal of pediatric surgery</title><addtitle>J Pediatr Surg</addtitle><description>Botulinum toxin (BT) is used to treat pediatric patients with Hirschsprung disease (HD) with obstructive symptoms. We aimed to characterize use of BT in HD patients across pediatric colorectal surgery referral centers.
A multicenter retrospective study of BT use in children (0–18y) with HD was performed using the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) between 2017 and 2021. Sites with <10 HD patients recorded were excluded. Patterns were evaluated using Fisher's exact, Wilcoxon rank-sum, Kruskal-Wallis, and Cochran-Armitage trend test.
494 patients at 8 centers were included. 118 (23.9%) received at least one BT injection. Among patients who required redo pullthrough procedures, 53.1% received BT compared to 22.7% of patients who only underwent one pullthrough (p<0.001). Age at pullthrough was also significantly associated (p = 0.021). A lower proportion of Hispanic patients received BT (9.6% vs. 26.3%;p = 0.006). Percentage of HD patients receiving BT varied significantly across sites (p<0.001).
Use of BT in patients with HD varies widely with greater use in patients who underwent redo surgery and in those who underwent pullthrough at an older age. Hispanic patients received less BT. These findings highlight the need to develop consensus guidelines and for further study on timing of injections and potential disparities in care.
III</description><subject>Botox</subject><subject>Botulinum toxin</subject><subject>Botulinum Toxins</subject><subject>Botulinum Toxins, Type A - therapeutic use</subject><subject>Child</subject><subject>Colorectal Surgery</subject><subject>Constipation</subject><subject>Endorectal pullthrough</subject><subject>Hirschsprung disease</subject><subject>Hirschsprung Disease - surgery</subject><subject>Humans</subject><subject>Referral and Consultation</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0022-3468</issn><issn>1531-5037</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUU1vEzEUtBCIpoW_UPnIZYM_4t3sDRRRilSJC5wt79vnxtFmvTzbQPkX_GMcpe0VaSRL9ozfmxnGrqVYSyHb94f1YcExFbpfK6HUWlQI84KtpNGyMUJ3L9lK1JdGb9rtBbtM6SBEvRbyNbvQRvVKtt2K_d3tHTnISOFPmO953iMvCXn0fIi5TGEuR57j7zDzisXlgHNO_FfIe34bKME-LVSqcAwJXRVmQpdx5C5zQo9EbqrKlEMuOcQ5cR-J19WDyxSAQ5wiIeTKOplBenjDXnk3JXz7eF6x7zefvu1um7uvn7_sPt41oNttbkbwnVbDuDV93w-d8GrTAxihwLVO950zDjxIDz32AyjTtQa1H8fBYeeklvqKvTv_u1D8UTBlewwJcJrcjLEkq9qNEBujtKrU9kwFiilVW3ahcHT0YKWwpzrswT7VYU91WFEhTBVeP84owxHHZ9lT_pXw4UzA6vRnQLIJasJQ8zmlYscY_jfjHy50pOU</recordid><startdate>202206</startdate><enddate>202206</enddate><creator>Rice-Townsend, Samuel E.</creator><creator>Nicassio, Lauren</creator><creator>Glazer, Debra</creator><creator>Avansino, Jeffrey</creator><creator>Durham, Megan M.</creator><creator>Calkins, Casey M.</creator><creator>Rentea, Rebecca M.</creator><creator>Ralls, Matthew W.</creator><creator>Wood, Richard J.</creator><creator>Rollins, Michael D.</creator><creator>Garvey, Erin M.</creator><creator>Lewis, Katelyn E.</creator><creator>Reeder, Ron</creator><creator>Smith, Caitlin A.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202206</creationdate><title>Characterizing the use of botulinum toxin in patients with Hirschsprung disease treated at referral institutions for pediatric colorectal surgery</title><author>Rice-Townsend, Samuel E. ; Nicassio, Lauren ; Glazer, Debra ; Avansino, Jeffrey ; Durham, Megan M. ; Calkins, Casey M. ; Rentea, Rebecca M. ; Ralls, Matthew W. ; Wood, Richard J. ; Rollins, Michael D. ; Garvey, Erin M. ; Lewis, Katelyn E. ; Reeder, Ron ; Smith, Caitlin A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c368t-dcf732bd85999b70f249cc502ca6a397a5acfc1fc9e9bc25765e3fddbae7a1313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Botox</topic><topic>Botulinum toxin</topic><topic>Botulinum Toxins</topic><topic>Botulinum Toxins, Type A - therapeutic use</topic><topic>Child</topic><topic>Colorectal Surgery</topic><topic>Constipation</topic><topic>Endorectal pullthrough</topic><topic>Hirschsprung disease</topic><topic>Hirschsprung Disease - surgery</topic><topic>Humans</topic><topic>Referral and Consultation</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rice-Townsend, Samuel E.</creatorcontrib><creatorcontrib>Nicassio, Lauren</creatorcontrib><creatorcontrib>Glazer, Debra</creatorcontrib><creatorcontrib>Avansino, Jeffrey</creatorcontrib><creatorcontrib>Durham, Megan M.</creatorcontrib><creatorcontrib>Calkins, Casey M.</creatorcontrib><creatorcontrib>Rentea, Rebecca M.</creatorcontrib><creatorcontrib>Ralls, Matthew W.</creatorcontrib><creatorcontrib>Wood, Richard J.</creatorcontrib><creatorcontrib>Rollins, Michael D.</creatorcontrib><creatorcontrib>Garvey, Erin M.</creatorcontrib><creatorcontrib>Lewis, Katelyn E.</creatorcontrib><creatorcontrib>Reeder, Ron</creatorcontrib><creatorcontrib>Smith, Caitlin A.</creatorcontrib><creatorcontrib>Pediatric Colorectal and Pelvic Learning Consortium (PCPLC)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rice-Townsend, Samuel E.</au><au>Nicassio, Lauren</au><au>Glazer, Debra</au><au>Avansino, Jeffrey</au><au>Durham, Megan M.</au><au>Calkins, Casey M.</au><au>Rentea, Rebecca M.</au><au>Ralls, Matthew W.</au><au>Wood, Richard J.</au><au>Rollins, Michael D.</au><au>Garvey, Erin M.</au><au>Lewis, Katelyn E.</au><au>Reeder, Ron</au><au>Smith, Caitlin A.</au><aucorp>Pediatric Colorectal and Pelvic Learning Consortium (PCPLC)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characterizing the use of botulinum toxin in patients with Hirschsprung disease treated at referral institutions for pediatric colorectal surgery</atitle><jtitle>Journal of pediatric surgery</jtitle><addtitle>J Pediatr Surg</addtitle><date>2022-06</date><risdate>2022</risdate><volume>57</volume><issue>6</issue><spage>1033</spage><epage>1039</epage><pages>1033-1039</pages><issn>0022-3468</issn><eissn>1531-5037</eissn><abstract>Botulinum toxin (BT) is used to treat pediatric patients with Hirschsprung disease (HD) with obstructive symptoms. We aimed to characterize use of BT in HD patients across pediatric colorectal surgery referral centers.
A multicenter retrospective study of BT use in children (0–18y) with HD was performed using the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) between 2017 and 2021. Sites with <10 HD patients recorded were excluded. Patterns were evaluated using Fisher's exact, Wilcoxon rank-sum, Kruskal-Wallis, and Cochran-Armitage trend test.
494 patients at 8 centers were included. 118 (23.9%) received at least one BT injection. Among patients who required redo pullthrough procedures, 53.1% received BT compared to 22.7% of patients who only underwent one pullthrough (p<0.001). Age at pullthrough was also significantly associated (p = 0.021). A lower proportion of Hispanic patients received BT (9.6% vs. 26.3%;p = 0.006). Percentage of HD patients receiving BT varied significantly across sites (p<0.001).
Use of BT in patients with HD varies widely with greater use in patients who underwent redo surgery and in those who underwent pullthrough at an older age. Hispanic patients received less BT. These findings highlight the need to develop consensus guidelines and for further study on timing of injections and potential disparities in care.
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Botox Botulinum toxin Botulinum Toxins Botulinum Toxins, Type A - therapeutic use Child Colorectal Surgery Constipation Endorectal pullthrough Hirschsprung disease Hirschsprung Disease - surgery Humans Referral and Consultation Retrospective Studies Treatment Outcome |
| title | Characterizing the use of botulinum toxin in patients with Hirschsprung disease treated at referral institutions for pediatric colorectal surgery |
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