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Colorectal conditions are of the most common and time-consuming conditions encountered by pediatric surgeons in low- and middle-income countries (LMIC). Factors such as delayed diagnosis, lack of surgeon and anesthesiologist expertise, lack of hospital facilities and availability of critical care, poverty and inadequate follow-up make it even more challenging. Most papers and management protocols are derived in high income countries (HIE) and may be inappropriate in these challenging settings. We look at the evidence of 2 common scenarios that are in HIC and see if they are appropriate in the LMIC setting. Question 1: Is a single stage repair (SSR) of an Ano-rectal malformation (ARM) equivalent to a staged repair (SR) and is it feasible in LMIC? Question 2: Should the availability or non-availability of frozen section influence the management of Hirschsprung disease in low and middle-income countries?

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Management of Anorectal Malformations and Hirschsprung’s Disease in Resource Challenged Settings?

  • 章节

  • 发表日期：

    2025年

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  • Chris Westgarth-Taylor,
  • Justina O. Seyi-Olajide,
  • Benedict C. Nwomeh,
  • Richard Wood

摘要

Colorectal conditions are of the most common and time-consuming conditions encountered by pediatric surgeons in low- and middle-income countries (LMIC). Factors such as delayed diagnosis, lack of surgeon and anesthesiologist expertise, lack of hospital facilities and availability of critical care, poverty and inadequate follow-up make it even more challenging. Most papers and management protocols are derived in high income countries (HIE) and may be inappropriate in these challenging settings. We look at the evidence of 2 common scenarios that are in HIC and see if they are appropriate in the LMIC setting. Question 1: Is a single stage repair (SSR) of an Ano-rectal malformation (ARM) equivalent to a staged repair (SR) and is it feasible in LMIC? Question 2: Should the availability or non-availability of frozen section influence the management of Hirschsprung disease in low and middle-income countries?