Alberto Peña, MD, Colorectal Center

  • Mission Trips

    The Peña Colorectal Center at Cincinnati Children’s is dedicated to providing care to children with anorectal or colorectal problems in all parts of the world.

    The founding director of the center, Alberto Peña, MD, his team and members from gynecology, urology, pediatric surgery, anesthesiology and nursing  travel to developing countries to teach surgical interventions and bowel management to physicians. Team members also provide in-kind surgical services to children in need.

    Trips

  • International Surgical Missions

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    Challenge

    Colorectal problems in children are relatively common. The congenital anomalies (anorectal malformation / imperforate anus and Hirschsprung’s disease) each occur in 1 in 5,000 births. Children are often managed with a newborn colostomy and then await definitive surgical correction.

    In the developing world, pediatric surgical caregivers are in short supply and advanced techniques to correct these conditions are often lacking. Luckily, the vast majority of children can be helped with operations and nursing care that can be taught to the local surgeons and nurses and are reproducible. 

    In each hospital, local pediatric caregivers usually exist as do the hospitals and operating rooms needed for care. What is lacking is training, some basic equipment, and an infrastructure of personnel for sustained care. In our experience these are readily accomplished with focused attention on training, and this ultimately can lead to a long-term impact.

    Approach

    Cincinnati Children’s Hospital Medical Center has one of the largest and best pediatric training and research programs in the United States and regularly partners with international academic institutions to share state-of-the-art knowledge and expertise. This includes development of opportunities for international professional exchanges, training and collaborative research, building international partnerships with local health care providers and developing of organizational structures that promote delivery of high-quality, efficient, family-centered and safe health care. Thus far we have collaborations with 66 institutions both domestic and international.

    In this context the Colorectal Center plans to send a surgical team to travel to sites as determined in collaboration with our Global Health team, where we can educate physicians and nurses as well as care for patients. Our goal is to perform surgery for pediatric colorectal problems over one week, two days of which will involve a course for the education of medical doctors, surgeons, and nurses from the host country and the surrounding countries for each country we plan to have a local pediatric surgeon first visit us in Cincinnati.

    This individual will organize surgeons from around the region to join the colorectal educational experience as well as organize patients to come from surrounding areas. We are hopeful that we can perform five to 10 operations a day for each of the days that we are there; with the specific focus of doing the types of cases that come up frequently to help the surgeons and nurses there improve the quality of care they can offer this unique group of pediatric surgical patients.

    Many of these children have received an initial colostomy at birth and are awaiting definitive colorectal reconstruction. Many are likely suffering from fecal incontinence and can be made clean by our techniques. We would plan to visit one site once a year for three years so that by the end of the three years the local team would be able to handle pediatric colorectal cases on their own. In this three year period we would have the local surgeons and nurses come to Cincinnati for further training. We believe that with this type of long-term plan sustainability can be achieved.

    If the local surgeon and hospital can provide similar care for their region, we have achieved our goals.

    Results

    Brief History

    The Peña Colorectal Center is the only comprehensive, multidisciplinary pediatric colorectal center in the world. It has developed and refined techniques that have become the standard for pediatric colorectal surgery, and helps children achieve bowel control with its unique Bowel Management Program. The center treats a variety of complex conditions, including anorectal malformations (also referred to as imperforate anus), Hirschsprung’s disease, inflammatory bowel disease, idiopathic constipation, intestinal pseudo-obstruction, fecal incontinence and familial polyposis.

    Since its infant stages (late 1980s) the Colorectal Center has provided training of local surgeons and children's colorectal surgeries throughout the world under the direction of the center founder and pioneer surgeon of the PSARP approach, Dr. Alberto Peña, and his team. Team members got the word out about the new procedure, which more effectively and safely corrected the anatomic problems these children are born with.

    Mission

    Our goals are always to both anatomically repair congenital malformations and achieve the best possible functional outcome to help each patient enjoy his or her best possible quality of life. This requires long-term care and close follow-up from the time of a patient’s first contact with our center, through childhood, and in some cases into adulthood.

    Outcomes

    • Each year our center sees nearly 400 patients with complex colorectal problems.
    • Our doctors have operated on more than 5,000 patients with anorectal malformations, Hirschsprung’s disease and other colorectal disorders.
    • The Bowel Management Program has a 95 percent success rate treating children with fecal incontinence and has cared for over 800 children with this problem.
    • Patients treated at our center have come from all 50 states and more than 80 countries.
    • We have a visiting surgeon and nurses program whereby physicians and nurses accompany their patients and observe the patient’s surgery and care.
    • Our physicians train surgeons from around the world and travel internationally to treat children with complex colorectal problems always focusing on helping the local team care for future patients and helping to build the infrastructure for this sustained care.
    • The Pediatric Anorectal and Colorectal Surgical Problems Workshop is given twice a year at Cincinnati Children's and four times a year at a variety of international sites. It highlights treatment techniques, demonstrates live surgical cases and welcomes pediatric surgeons, urologists, gynecologists, gastroenterologists and nurses who manage patients with colorectal issues.

    Assistance Needed for each Mission

    • Staff transportation
    • Staff lodging
    • Supplies and equipment

    Funding for a mission includes coverage of costs for the surgical team (approximately 20-25 team members), including pediatric surgeons, operating room nurses, clinical nurses, coordinators, and additional non-medical personnel. Costs involve coverage of flights, accommodations, supplies and equipment for the cases, and supplies and equipment for the course. We estimate the cost for each mission will run from $60,000 to $85,000. In one week’s time we likely can care for 25-50 patients so when one considers the overall number of children helped by this exchange of ideas and knowledge, the impact is far greater.

    Gretchen J. Niebling, CAPPM, CPC
    Program Coordinator
    Gretchen.Niebling@cchmc.org

    Peña Colorectal Center
    Cincinnati Children’s Hospital Medical Center
    3333 Burnet Avenue, ML 2023
    Cincinnati, OH 45229
    Phone: 513-636-3240
    Fax: 513-636-3248


 
  • How You Can Help

    Donate online, or to learn how you can support outreach efforts at the Peña Colorectal Center at Cincinnati Children’s, contact:

    Gretchen J. Niebling, CAPPM, CPC
    Program Coordinator
    Gretchen.Niebling@cchmc.org
    Phone: 513-636-3240