Newswise — According to 2015 National Health Interview Survey data published by the Center for Disease Control and Prevention, it is estimated that about 85% of children under the age of 18 are in excellent or very good health. What happens to the rest? Many are considered “Children with Special Healthcare Needs” (CSHCN) and have special healthcare requirements, perhaps due to common chronic conditions of childhood such as asthma, autism spectrum disorders, or uncommon ones as described in the March issue of Diseases of the Colon & Rectum. Dr. Sarah Cairo and her colleagues from the Delivery of Surgical Care Committee of the American Academy of Pediatrics, Section on Surgery, discuss the unique situation facing pediatric patients with congenital anal rectal malformations as they grow older and face the transition from pediatric to adult health care.

This article and topic have wide-reaching implications for countless other medical problems that affect the pediatric age group. Dr. Cairo and her colleagues provide easy-to-use checklists to help the patient, their family, and their medical team regularly assess whether or not the patient is ready for this major step and transition in care, emphasizing that such transitions are easier with a team-based approach. This is particularly true with the type of patient that is the focus of this article.  These individuals often have multiple problems including difficulties with bowel, bladder, and sexual function as well as psychological issues.

Many hospitals destroy medical records and radiographs after a period of 10 years. This is particularly difficult when the patient is a young person who has undergone one or more complex operations to correct a congenital abnormality, and there is no longer a record of what was done. Many of these patients have to travel to special centers for their care. Currently, different hospitals and healthcare systems have electronic medical records that in many cases do not communicate with each other. Keeping track of personal medical records is in the best interest of the patient and the patient’s family, which is something the article stresses.

Citation: Cairo SB, Gasior A, Rollins MD, Rothstein, DH; the Delivery of Surgical Care Committee of the American Academy of Pediatrics Section on Surgery. Challenges in transition of care for patients with anorectal malformations: a systematic review and recommendations for comprehensive care. Dis Colon Rect. 2018;61(3):390-399.

Accompanying this article is an editorial by Mary E. Fallat, MD, immediate past president of the American Pediatric Surgical Association. Dr. Fallat wisely describes the importance of the individual patient taking ownership of his or her own healthcare, and their disease and its consequences, and understanding which providers need to be part of their healthcare team. At times, the surgeon may even be the best person to serve as the patients “primary medical home,” depending upon the condition. These transitions will affect the spectrum of providers who will care for an individual patient including generalists and specialists and require coordinated care and communication, and care that is patient and family-centered, to succeed.


Citation: Fallat ME. Facilitating transitions from pediatric to adult surgical care. Dis Colon Rectum. 2018;61(3):271-272.


A prepublication copy is available upon request. Please email Margaret Abby, Managing Editor, Diseases of the Colon and Rectum, at [email protected]