What should be the treatment for intestinal neuronal dysplasia type B? A comparative long-term follow-up study

Detalhes bibliográficos
Autor(a) principal: Lourenção, Pedro Luiz Toledo de Arruda [UNESP]
Data de Publicação: 2020
Outros Autores: Ortolan, Erika Veruska Paiva [UNESP], Rosa, Laura Luiza Minelli [UNESP], Angelini, Marcos Curcio [UNESP], Cassettari, Vanessa Mello Granado [UNESP], Terra, Simone Antunes [UNESP], Rodrigues, Maria Aparecida Marchesan [UNESP]
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNESP
Texto Completo: http://dx.doi.org/10.1016/j.jpedsurg.2020.11.019
http://hdl.handle.net/11449/206915
Resumo: Purpose: To present the long-term follow-up outcomes of patients with intestinal neuronal dysplasia type B (IND-B) managed either conservatively or surgically. Methods: We conducted an ambispective, observational, longitudinal, and comparative study. Clinical data were reviewed at the start of treatment. After a minimum period of five years, the patients participated in semi-structured interviews in which the bowel function score (BFS) was applied to assess intestinal function, a proposed intestinal symptom index (ISI) to assess clinical symptoms, and a classification of clinical prognosis to assess treatment success. Comparisons between the two types of treatment were performed by evaluating pre- and post-treatment criteria. Results: Fifty patients diagnosed with IND-B were included in the study. Thirty-eight patients underwent surgical treatment (26 elective surgical treatment for primary colorectal resection and 12 emergency colostomies for intestinal obstruction or enterocolitis). Twelve patients were managed conservatively. With the exception of the patients who required an emergency operation (n = 12), the two groups were composed of patients with severe constipation who had similar clinical and functional characteristics at the time of IND-B diagnosis. A better clinical response was observed in patients submitted to conservative treatment, with a greater increase in the BFS (16.5 [-4/+18] versus 4 [-15/+17]; p = 0.001), indicating better bowel function and a more pronounced drop in ISI (-6 [-7/-4] versus -4 [-6/+1]; p = 0.015), suggesting fewer symptoms. The percentage of patients who had a successful treatment was higher in the group treated conservatively (72.7% versus 42.3%; p = 0.03). Conclusion: Conservative management showed better long-term outcomes than surgical management in children with IND-B.
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spelling What should be the treatment for intestinal neuronal dysplasia type B? A comparative long-term follow-up studyChildConstipationEnteric nervous systemIntestinal neuronal dysplasia type BPurpose: To present the long-term follow-up outcomes of patients with intestinal neuronal dysplasia type B (IND-B) managed either conservatively or surgically. Methods: We conducted an ambispective, observational, longitudinal, and comparative study. Clinical data were reviewed at the start of treatment. After a minimum period of five years, the patients participated in semi-structured interviews in which the bowel function score (BFS) was applied to assess intestinal function, a proposed intestinal symptom index (ISI) to assess clinical symptoms, and a classification of clinical prognosis to assess treatment success. Comparisons between the two types of treatment were performed by evaluating pre- and post-treatment criteria. Results: Fifty patients diagnosed with IND-B were included in the study. Thirty-eight patients underwent surgical treatment (26 elective surgical treatment for primary colorectal resection and 12 emergency colostomies for intestinal obstruction or enterocolitis). Twelve patients were managed conservatively. With the exception of the patients who required an emergency operation (n = 12), the two groups were composed of patients with severe constipation who had similar clinical and functional characteristics at the time of IND-B diagnosis. A better clinical response was observed in patients submitted to conservative treatment, with a greater increase in the BFS (16.5 [-4/+18] versus 4 [-15/+17]; p = 0.001), indicating better bowel function and a more pronounced drop in ISI (-6 [-7/-4] versus -4 [-6/+1]; p = 0.015), suggesting fewer symptoms. The percentage of patients who had a successful treatment was higher in the group treated conservatively (72.7% versus 42.3%; p = 0.03). Conclusion: Conservative management showed better long-term outcomes than surgical management in children with IND-B.Department of Surgery Division of Pediatric Surgery Botucatu Medical School UNESP - São Paulo State UniversityBotucatu Medical School UNESP - São Paulo State UniversityDepartment of Pathology Botucatu Medical School UNESP - São Paulo State UniversityDepartment of Surgery Division of Pediatric Surgery Botucatu Medical School UNESP - São Paulo State UniversityBotucatu Medical School UNESP - São Paulo State UniversityDepartment of Pathology Botucatu Medical School UNESP - São Paulo State UniversityUniversidade Estadual Paulista (Unesp)Lourenção, Pedro Luiz Toledo de Arruda [UNESP]Ortolan, Erika Veruska Paiva [UNESP]Rosa, Laura Luiza Minelli [UNESP]Angelini, Marcos Curcio [UNESP]Cassettari, Vanessa Mello Granado [UNESP]Terra, Simone Antunes [UNESP]Rodrigues, Maria Aparecida Marchesan [UNESP]2021-06-25T10:45:54Z2021-06-25T10:45:54Z2020-01-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1016/j.jpedsurg.2020.11.019Journal of Pediatric Surgery.1531-50370022-3468http://hdl.handle.net/11449/20691510.1016/j.jpedsurg.2020.11.0192-s2.0-85097102656Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengJournal of Pediatric Surgeryinfo:eu-repo/semantics/openAccess2024-09-03T13:46:52Zoai:repositorio.unesp.br:11449/206915Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestrepositoriounesp@unesp.bropendoar:29462024-09-03T13:46:52Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false
dc.title.none.fl_str_mv What should be the treatment for intestinal neuronal dysplasia type B? A comparative long-term follow-up study
title What should be the treatment for intestinal neuronal dysplasia type B? A comparative long-term follow-up study
spellingShingle What should be the treatment for intestinal neuronal dysplasia type B? A comparative long-term follow-up study
Lourenção, Pedro Luiz Toledo de Arruda [UNESP]
Child
Constipation
Enteric nervous system
Intestinal neuronal dysplasia type B
title_short What should be the treatment for intestinal neuronal dysplasia type B? A comparative long-term follow-up study
title_full What should be the treatment for intestinal neuronal dysplasia type B? A comparative long-term follow-up study
title_fullStr What should be the treatment for intestinal neuronal dysplasia type B? A comparative long-term follow-up study
title_full_unstemmed What should be the treatment for intestinal neuronal dysplasia type B? A comparative long-term follow-up study
title_sort What should be the treatment for intestinal neuronal dysplasia type B? A comparative long-term follow-up study
author Lourenção, Pedro Luiz Toledo de Arruda [UNESP]
author_facet Lourenção, Pedro Luiz Toledo de Arruda [UNESP]
Ortolan, Erika Veruska Paiva [UNESP]
Rosa, Laura Luiza Minelli [UNESP]
Angelini, Marcos Curcio [UNESP]
Cassettari, Vanessa Mello Granado [UNESP]
Terra, Simone Antunes [UNESP]
Rodrigues, Maria Aparecida Marchesan [UNESP]
author_role author
author2 Ortolan, Erika Veruska Paiva [UNESP]
Rosa, Laura Luiza Minelli [UNESP]
Angelini, Marcos Curcio [UNESP]
Cassettari, Vanessa Mello Granado [UNESP]
Terra, Simone Antunes [UNESP]
Rodrigues, Maria Aparecida Marchesan [UNESP]
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidade Estadual Paulista (Unesp)
dc.contributor.author.fl_str_mv Lourenção, Pedro Luiz Toledo de Arruda [UNESP]
Ortolan, Erika Veruska Paiva [UNESP]
Rosa, Laura Luiza Minelli [UNESP]
Angelini, Marcos Curcio [UNESP]
Cassettari, Vanessa Mello Granado [UNESP]
Terra, Simone Antunes [UNESP]
Rodrigues, Maria Aparecida Marchesan [UNESP]
dc.subject.por.fl_str_mv Child
Constipation
Enteric nervous system
Intestinal neuronal dysplasia type B
topic Child
Constipation
Enteric nervous system
Intestinal neuronal dysplasia type B
description Purpose: To present the long-term follow-up outcomes of patients with intestinal neuronal dysplasia type B (IND-B) managed either conservatively or surgically. Methods: We conducted an ambispective, observational, longitudinal, and comparative study. Clinical data were reviewed at the start of treatment. After a minimum period of five years, the patients participated in semi-structured interviews in which the bowel function score (BFS) was applied to assess intestinal function, a proposed intestinal symptom index (ISI) to assess clinical symptoms, and a classification of clinical prognosis to assess treatment success. Comparisons between the two types of treatment were performed by evaluating pre- and post-treatment criteria. Results: Fifty patients diagnosed with IND-B were included in the study. Thirty-eight patients underwent surgical treatment (26 elective surgical treatment for primary colorectal resection and 12 emergency colostomies for intestinal obstruction or enterocolitis). Twelve patients were managed conservatively. With the exception of the patients who required an emergency operation (n = 12), the two groups were composed of patients with severe constipation who had similar clinical and functional characteristics at the time of IND-B diagnosis. A better clinical response was observed in patients submitted to conservative treatment, with a greater increase in the BFS (16.5 [-4/+18] versus 4 [-15/+17]; p = 0.001), indicating better bowel function and a more pronounced drop in ISI (-6 [-7/-4] versus -4 [-6/+1]; p = 0.015), suggesting fewer symptoms. The percentage of patients who had a successful treatment was higher in the group treated conservatively (72.7% versus 42.3%; p = 0.03). Conclusion: Conservative management showed better long-term outcomes than surgical management in children with IND-B.
publishDate 2020
dc.date.none.fl_str_mv 2020-01-01
2021-06-25T10:45:54Z
2021-06-25T10:45:54Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1016/j.jpedsurg.2020.11.019
Journal of Pediatric Surgery.
1531-5037
0022-3468
http://hdl.handle.net/11449/206915
10.1016/j.jpedsurg.2020.11.019
2-s2.0-85097102656
url http://dx.doi.org/10.1016/j.jpedsurg.2020.11.019
http://hdl.handle.net/11449/206915
identifier_str_mv Journal of Pediatric Surgery.
1531-5037
0022-3468
10.1016/j.jpedsurg.2020.11.019
2-s2.0-85097102656
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Journal of Pediatric Surgery
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv Scopus
reponame:Repositório Institucional da UNESP
instname:Universidade Estadual Paulista (UNESP)
instacron:UNESP
instname_str Universidade Estadual Paulista (UNESP)
instacron_str UNESP
institution UNESP
reponame_str Repositório Institucional da UNESP
collection Repositório Institucional da UNESP
repository.name.fl_str_mv Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)
repository.mail.fl_str_mv repositoriounesp@unesp.br
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