Colorectal Center Celebrates Milestone
In January, the Colorectal Center for Children celebrated a milestone -- the 2,000th posterior sagittal anorectoplasty (PSARP), which is a novel surgical approach to repair colorectal problems that was pioneered by Alberto Peña, MD, director. The Colorectal Center for Children is the world's only comprehensive and multidisciplinary center specializing in the treatment of anorectal malformations, Hirschprung's Disease and issues related to the bowel, including constipation and fecal incontinence in children.
It was August, 1980, when Peña attempted a new surgical approach – the PSARP, which has also become known as the "Peña pull-through procedure." The surgery is performed with the patient in the prone position (face down) and entails a midline posterior sagittal incision running from the sacrum, or last bone of the spine, to the edge of the anal sphincter. The technique proved successful and forever changed the treatment and management of colorectal patients. Dr. Peña continued to dedicate himself to working with patients and their families in the field of anorectal malformations at Schneider Children's Hospital in New York, and in 1992, Marc Levitt, MD, joined him in his efforts.
To give perspective to this accomplishment, the 1,000th PSARP surgery was performed in 1996. In July 2005, Drs. Peña and Levitt moved to Cincinnati Children's in order to provide a setting where a multidisciplinary approach and resource availability would meet the patient's highly complex needs. Shortly after the Colorectal Center for Children was established, Richard Falcone, MD, joined the team. In addition, collaborative efforts with Lesley Breech, MD, an assistant professor of gynecology and obstetrics, Curt Sheldon, MD, director, Urology, and Michael Bates, MD, PhD, of Gastroenterology, among others, were formed to strengthen the comprehensive approach of care for patients.
Not only has the work of the Colorectal Center for Children improved the lives of their patients; it has also provided a wealth of research. Of the 2,000 surgeries, 90 percent were performed for a diagnosis of an anorectal malformation and 10 percent for other reasons, such as Hirschsprung's disease, trauma, cancer, etc.
The research data the surgeries have provided has led to contributions in over 200 textbook chapters and peer-reviewed articles furthering education and answering previously unknown questions as a result.
In the short time since the Colorectal Center for Children was established in Cincinnati, over 25 articles and textbook chapters have been published, all of which stemmed from data provided through experience with the PSARP procedure. In addition to the research, the 2,000 surgeries performed have provided ample opportunity to teach colleagues from around the world and paved the way for a dedicated workshop on anorectal malformations that is taught biannually on PSARP techniques and experience learned over the years.
