Bokova Elizaveta, Elhalaby Ismael, Saylors Seth, Lim Irene Isabel P, Rentea Rebecca M
Comprehensive Colorectal Center, Department of Surgery, Children's Mercy Hospital, Kansas City, MO 64108, USA.
Tanta University Hospital, Faculty of Medicine, Tanta University, Tanta 31527, Egypt.
Children (Basel). 2024 Jun 27;11(7):786. doi: 10.3390/children11070786.
Recent advancements in pediatric surgery have embraced telehealth (TH) modalities, transitioning from traditional in-person consultations to virtual care. This shift has broadened access to healthcare, potentially enhancing affordability, patient and caregiver satisfaction, and clinical outcomes. In pediatric colorectal surgery, telehealth has been effectively utilized to support Bowel Management Programs (BMPs) for children suffering from constipation and fecal incontinence. A systematic review was conducted to assess the effectiveness of virtual BMPs, analyzing studies from January 2010 to December 2023, sourced from MEDLINE (via PubMed), Embase, and the Cochrane Library, with five studies included. Remote BMPs, implemented through video or telephone consultations, reported satisfaction rates exceeding 75% among families, indicating a strong preference for virtual interactions over traditional visits. Significant findings from the studies include improvements in Vancouver and Baylor scores, reductions in the duration of multidisciplinary consultations, enhancements in pediatric quality of life and Cleveland scores, and decreased frequency of laxative treatments. The implementation of TH has facilitated patient-led care, enabling timely adjustments in treatment and efficient distribution of medical supplies. The findings suggest that virtual BMPs are a viable and effective alternative to conventional approaches, yielding high caregiver satisfaction and superior clinical outcomes while promoting patient independence.
小儿外科的最新进展采用了远程医疗（TH）模式，从传统的面对面咨询转向虚拟护理。这一转变扩大了医疗服务的可及性，有可能提高可负担性、患者及护理人员的满意度以及临床疗效。在小儿结直肠外科，远程医疗已被有效用于支持针对便秘和大便失禁儿童的肠道管理计划（BMPs）。进行了一项系统综述，以评估虚拟BMPs的有效性，分析了2010年1月至2023年12月期间来自MEDLINE（通过PubMed）、Embase和Cochrane图书馆的研究，共纳入五项研究。通过视频或电话咨询实施的远程BMPs报告称，家庭满意度超过75%，表明与传统就诊相比，对虚拟互动有强烈偏好。这些研究的重要发现包括温哥华和贝勒评分有所改善、多学科会诊时长缩短、小儿生活质量和克利夫兰评分提高以及泻药治疗频率降低。远程医疗的实施促进了以患者为主导的护理，能够及时调整治疗并高效分发医疗用品。研究结果表明，虚拟BMPs是传统方法的一种可行且有效的替代方案，能让护理人员高度满意，产生卓越的临床疗效，同时促进患者的独立性。
