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Surgical management of neurogenic bowel in centers participating in National Spina Bifida Patient Registry.

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eMediNexus    29 December 2017

A new study published in the Journal of Pediatric Rehabilitation Medicine queried the National Spina Bifida Patient Registry (NSBPR) to identify patients who underwent surgical interventions for neurogenic bowel. Here, demographic characteristics, spina bifida (SB) type, functional level, concurrent bladder surgery, mobility, and NSBPR clinics were abstracted to determine whether any of these factors were associated with interventions for management of neurogenic bowel. The study identified 5,528 patients with SB enrolled in the 2009-14 NSBPR. It was found that 19.7% of these patients underwent procedures for neurogenic bowel: 17.3% ACE/cecostomy tube and 155 2.8% ileostomy/colostomy. Additionally, among those who had higher probability to undergo surgery were, older, white, non-ambulatory patients, with higher-level lesion, with myelomeningocele lesion, with private health insurance, as well as females. Whereas, children were less likely to undergo surgical intervention. On multivariable analysis, NSBPR clinic, older age, race, mobility status, higher lesion level, private insurance and female sex were associated with increased odds of surgery. Thus, it was concluded that there is significant variation in rates of procedures to manage neurogenic bowel among NSBPR clinics. It was stated that apart from to SB-related factors such as mobility status and lesion type/level, non-SB-related factors such as patient age, sex, race and treating center are also associated with the likelihood of undergoing neurogenic bowel intervention.

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