A descriptive model for a multidisciplinary unit for colorectal and pelvic malformations

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Urology
• Gynecology
• Developmental Biology

Background:

• Patients with anorectal malformations (ARM), Hirschsprung disease (HD), and colonic motility disorders require multidisciplinary care.
• Existing care models often involve fragmented specialist involvement.

Purpose of the Study:

• To describe the creation and function of a dedicated center for complex colorectal and pelvic malformations.
• To establish a collaborative process for managing these rare conditions.

Main Methods:

• Developed a devoted center with physicians, psychologists, social workers, nurses, and advanced practice nurses.
• Implemented weekly multidisciplinary meetings for patient review.
• Conducted combined exams and surgical interventions as needed.

Main Results:

• The center cared for 1258 patients from 2014-2017, including ARM, HD, neurogenic bowel, and functional constipation.
• A total of 514 patients were seen in the bowel management program.
• The center involved 31 staff members and facilitated 170 multidisciplinary meetings.

Conclusions:

• This is the first report on a multidisciplinary team approach for complex colorectal and pelvic malformations.
• Collaborative care facilitates combined medical and surgical decisions, potentially improving patient outcomes.
• This model can guide the establishment of similar centers for centralized care of rare malformations.