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A comparative observational study on intrasphincteric injections with Botulinum toxin vs. enteral neuromodulation in chronic refractory constipation.
Walther, Mona; Müller, Hanna; Weiß, Christel; Carbon, Roman; Diez, Sonja; Besendörfer, Manuel.
Afiliação
  • Walther M; Department of Surgery, Section of Pediatric Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Loschgestrasse 15, 91054, Erlangen, Germany.
  • Müller H; Neonatology and Pediatric Intensive Care, Department of Pediatrics, University Hospital Marburg, 35043, Baldingerstraße, Marburg, Germany.
  • Weiß C; Department of Medical Statistics, Biomathematics, and Information Processing, Medical Faculty, Mannheim of Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
  • Carbon R; Department of Surgery, Section of Pediatric Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Loschgestrasse 15, 91054, Erlangen, Germany.
  • Diez S; Department of Surgery, Section of Pediatric Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Loschgestrasse 15, 91054, Erlangen, Germany. sonja.diez@uk-erlangen.de.
  • Besendörfer M; Department of Surgery, Section of Pediatric Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Loschgestrasse 15, 91054, Erlangen, Germany.
BMC Pediatr ; 23(1): 448, 2023 09 08.
Article em En | MEDLINE | ID: mdl-37684559
PURPOSE: Botulinum toxin injections in the anal sphincter apparatus (Botox) and enteral neuromodulation (ENM) are options for treatment of refractory chronic constipation. We present a retrospective comparative observational study. PATIENTS AND METHODS: From 2014 to 2022, pediatric patients with chronic constipation were either treated with Botox or ENM with continuation of conservative treatment. Comparison was conducted regarding the primary outcome variables defecation frequency, stool consistency, and abdominal pain. Secondary outcomes were fecal incontinence, enuresis, change of medication and safety of treatment. RESULTS: 19 Botox patients (10 boys, 9 girls, 12 patients with Hirschsprung disease (HD), 7 patients with functional constipation (FC)) were compared to 24 ENM patients (18 boys, 6 girls, 12 HD patients, 7 FC patients). Groups differed significantly in age (5.0 years (Botulinum toxin) and 6.5 years (ENM), mean values, p-value 0.008). Improvement of constipation was seen in 68% (n = 13/19) of Botox and 88% (n = 21/24) of ENM patients (p = 0.153). Influence of etiology on therapeutic effects was not observed. Complications were minor. CONCLUSIONS: Botox and ENM can be considered as valuable and effective treatment options in refractory chronic constipation. Prospective, large-population studies should be designed to enable improved evidence.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Toxinas Botulínicas Tipo A Tipo de estudo: Observational_studies Limite: Child / Child, preschool / Female / Humans / Male Idioma: En Revista: BMC Pediatr Assunto da revista: PEDIATRIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Toxinas Botulínicas Tipo A Tipo de estudo: Observational_studies Limite: Child / Child, preschool / Female / Humans / Male Idioma: En Revista: BMC Pediatr Assunto da revista: PEDIATRIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Alemanha