SHORT ANSWER
Advances and Answers in Pediatric Health
Ranked #1 in
Gastroenterology
and GI Surgery
Children’s Hospital Colorado’s Digestive Health
Institute earned the top spot this year in U.S. News
& World Report due in part to its outstanding
clinical and surgical outcomes and patient safety
for children with GI and liver diseases. Many of the
Institute’s providers are also involved in various
initiatives that continue to push the boundaries of
clinical care, with recent publications including:
1. Stahl MG, Geno Rasmussen C, Dong F, et al. Mass
Screening for Celiac Disease: The Autoimmunity
Screening for Kids Study [published online ahead of
print, 2020 Jul 22]. Am J Gastroenterol. 2020.
2. Khalaf RT, Sokol RJ. New Insights Into
Intestinal Failure-Associated Liver Disease in
Children. Hepatology. 2020;71(4):1486-1498.
3. Mack CL, Adams D, Assis DN, et al. Diagnosis and
Management of Autoimmune Hepatitis in Adults
and Children: 2019 Practice Guidance and Guidelines
From the American Association for the Study of Liver
Diseases [published online ahead of print, 2019 Dec
21]. Hepatology. 2019
4. Ackerman SJ, Kagalwalla AF, Hirano I, et al. One-
Hour Esophageal String Test: A Nonendoscopic
Minimally Invasive Test That Accurately Detects
Disease Activity in Eosinophilic Esophagitis. Am J
Gastroenterol. 2019;114(10):1614-1625.
5. Nguyen N, Lavery WJ, Capocelli KE, et al. Transnasal
Endoscopy in Unsedated Children With Eosinophilic
Esophagitis Using Virtual Reality Video Goggles. Clin
Gastroenterol Hepatol. 2019;17(12):2455-2462.
6. Feldman AG, Beaty BL, Curtis D, Juarez-Colunga E,
Kempe A. Incidence of Hospitalization for Vaccine-
Preventable Infections in Children Following Solid
Organ Transplant and Associated Morbidity, Mortality,
and Costs. JAMA Pediatr. 2019;173(3):260-268.
The Digestive Health Institute is open for
second opinions and referrals.
The Pioneer of Pull-Through
Celebrating the 40th Anniversary of the Peña Pull-
Through Procedure
COLORECTAL AND UROGENITAL CARE
Prior to 1980, the best way for colorectal surgeons to access an anorectal
malformation was through the abdomen or through the perineum. Neither option
allowed surgeons to directly see the intrinsic anatomy of the malformation. They were
essentially blind entries that frequently injured nerves and the urogenital tract.
In 1980, pediatric colorectal surgeon Alberto Peña, MD, introduced the posterior
sagittal anorectoplasty, or PSARP, also known as the Peña Pull-Through Procedure.
The patient lies in prone position, which allows the surgeon a clearer view of the
anatomy for operation. The method transformed treatment for children with
anorectal malformations, greatly reducing the risk of lifelong urinary and bowel
incontinence and loss of sexual function. It’s now the treatment standard throughout
the world.
Dr. Peña subsequently adapted PSARP to help treat cloaca. That method is called the
posterior sagittal anorectal vaginal urethroplasty, or PSARVUP. It includes additional
surgical maneuvers to effectively reconstruct the patient’s long common channel.
Additional adaptions of PSARP help treat conditions including:
• Urogenital sinus anomaly
• Presacral masses
• Acquired recto-urethral fistulas
• Recto-vaginal fistulas
• Vaginal atresia
• Reoperations for Hirschsprung
disease and other urogenital
anomalies
Today, Dr. Peña helps lead the International Center for Colorectal and Urogenital Care
at Children’s Hospital Colorado along with renowned pediatric colorectal surgeons
Andrea Bischoff, MD, and Luis De La Torre, MD. Each year, all three surgeons host the
Peña Course — a three-day intensive workshop with live surgical demonstrations. The
course is designed to provide pediatric specialists, such as surgeons, urologists and
gynecologists, an in-depth understanding of the Peña Pull-Through Procedure and
how to perform its intricate maneuvers. •
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