{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:03:57Z","timestamp":1792083837889,"version":"4.4.0"},"reference-count":57,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T00:00:00Z","timestamp":1719446400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/children11070786","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T13:26:43Z","timestamp":1719494803000},"page":"786","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A Systematic Review of Telehealth Utilization for Bowel Management Programs in Pediatric Colorectal Surgery"],"prefix":"10.3390","volume":"11","author":[{"given":"Elizaveta","family":"Bokova","sequence":"first","affiliation":[{"name":"Comprehensive Colorectal Center, Department of Surgery, Children\u2019s Mercy Hospital, Kansas City, MO 64108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2669-9724","authenticated-orcid":false,"given":"Ismael","family":"Elhalaby","sequence":"additional","affiliation":[{"name":"Comprehensive Colorectal Center, Department of Surgery, Children\u2019s Mercy Hospital, Kansas City, MO 64108, USA"},{"name":"Tanta University Hospital, Faculty of Medicine, Tanta University, Tanta 31527, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth","family":"Saylors","sequence":"additional","affiliation":[{"name":"Comprehensive Colorectal Center, Department of Surgery, Children\u2019s Mercy Hospital, Kansas City, MO 64108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene Isabel P.","family":"Lim","sequence":"additional","affiliation":[{"name":"Comprehensive Colorectal Center, Department of Surgery, Children\u2019s Mercy Hospital, Kansas City, MO 64108, USA"},{"name":"Department of Surgery, University of Missouri-Kansas City, Kansas City, MO 64108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8689-5989","authenticated-orcid":false,"given":"Rebecca M.","family":"Rentea","sequence":"additional","affiliation":[{"name":"Comprehensive Colorectal Center, Department of Surgery, Children\u2019s Mercy Hospital, Kansas City, MO 64108, USA"},{"name":"Department of Surgery, University of Missouri-Kansas City, Kansas City, MO 64108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1016\/j.jpedsurg.2021.04.029","article-title":"One-Year Impact of a Bowel Management Program in Treating Fecal Incontinence in Patients with Anorectal Malformations","volume":"56","author":"Wood","year":"2021","journal-title":"J. Pediatr. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e7078","DOI":"10.1097\/MD.0000000000007078","article-title":"Bowel Management Program for Pediatric Postoperative Fecal Incontinence in China: A Surgeon\u2019s Experience","volume":"96","author":"Wang","year":"2017","journal-title":"Medicine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1007\/s00383-023-05574-z","article-title":"Pilot bowel management program at Mbarara Hospital, Uganda","volume":"39","author":"Trinidad","year":"2023","journal-title":"Pediatr. Surg. Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/j.jpedsurg.2014.08.006","article-title":"Effectiveness of an Organized Bowel Management Program in the Management of Severe Chronic Constipation in Children","volume":"50","author":"Russell","year":"2015","journal-title":"J. Pediatr. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1007\/s00383-016-3874-5","article-title":"Impact of the Bowel Management Program on the Quality of Life in Children with Fecal Incontinence","volume":"32","author":"Colares","year":"2016","journal-title":"Pediatr. Surg. Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1016\/j.jpedsurg.2018.01.002","article-title":"Are Senna Based Laxatives Safe When Used as Long Term Treatment for Constipation in Children?","volume":"53","author":"Gasior","year":"2018","journal-title":"J. Pediatr. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.pedneo.2012.06.007","article-title":"Constipation Is a Major Complication after Posterior Sagittal Anorectoplasty for Anorectal Malformations in Children","volume":"53","author":"Huang","year":"2012","journal-title":"Pediatr. Neonatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1007\/s00383-020-04843-5","article-title":"Delayed Presentation of Anorectal Malformations in a Tertiary Care Hospital in India","volume":"37","author":"Divya","year":"2021","journal-title":"Pediatr. Surg. Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e000195","DOI":"10.1136\/wjps-2020-000195","article-title":"Impact of Distance on Postoperative Follow-up in Patients of Pediatric Surgery: A Retrospective Review","volume":"3","author":"Wiebe","year":"2020","journal-title":"World J. Pediatr. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e042969","DOI":"10.1136\/bmjopen-2020-042969","article-title":"Geospatial Analysis of Pediatric Surgical Need and Geographical Access to Care in Somaliland: A Cross-Sectional Study","volume":"11","author":"Moody","year":"2021","journal-title":"BMJ Open"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1016\/j.jpedsurg.2021.02.018","article-title":"The Value of Telemedicine for the Pediatric Surgery Patient in the Time of COVID-19 and Beyond","volume":"56","author":"Metzger","year":"2021","journal-title":"J. Pediatr. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.jpedsurg.2021.11.018","article-title":"Telemedicine (Virtual Clinic) Effectively Delivers the Required Healthcare Service for Pediatric Ambulatory Surgical Patients during the Current Era of COVID-19 Pandemic: A Mixed Descriptive Study","volume":"57","author":"Mahmoud","year":"2022","journal-title":"J. Pediatr. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.jpedsurg.2021.09.012","article-title":"Outcomes of a Telemedicine Bowel Management Program during COVID-19","volume":"57","author":"Knaus","year":"2022","journal-title":"J. Pediatr. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e000257","DOI":"10.1136\/wjps-2020-000257","article-title":"State of Telemedicine Use in Pediatric Surgery in the USA-Where We Stand and What We Can Gain from the COVID-19 Pandemic: A Scoping Review","volume":"4","author":"Metzger","year":"2021","journal-title":"World J. Pediatr. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.jss.2022.02.023","article-title":"Examining the Utility of Preoperative Telemedicine Care Across Multiple Pediatric Surgery Disciplines","volume":"277","author":"Metzger","year":"2022","journal-title":"J. Surg. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.jss.2021.05.019","article-title":"Recognizing the Benefit of Telemedicine Before and After COVID-19: A Survey of Pediatric Surgery Providers","volume":"267","author":"Metzger","year":"2021","journal-title":"J. Surg. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1503\/cjs.005918","article-title":"Improving Value and Access to Specialty Medical Care for Families: A Pediatric Surgery Telehealth Program","volume":"62","author":"Dean","year":"2019","journal-title":"Can. J. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1089\/lap.2017.0294","article-title":"Public Perception of Telemedicine and Surgical Telementoring in the Pediatric Population: Results of a Parental Survey","volume":"28","author":"Abdulhai","year":"2018","journal-title":"J. Laparoendosc. Adv. Surg. Tech."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"5760","DOI":"10.1007\/s00464-020-08055-9","article-title":"Using Telemedicine on an Acute Care Surgery Service: Improving Clinic Efficiency and Access to Care","volume":"35","author":"Parnell","year":"2021","journal-title":"Surg. Endosc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1089\/tmj.2018.0246","article-title":"Impact of Telemedicine in Pediatric Postoperative Care","volume":"25","author":"Young","year":"2019","journal-title":"Telemed. e-Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.paed.2021.07.004","article-title":"Telemedicine: Improving Clinical Care and Medical Education in Paediatrics","volume":"31","author":"Macwilliam","year":"2021","journal-title":"Paediatr. Child Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1097\/MOP.0000000000000763","article-title":"Rural Health, Telemedicine and Access for Pediatric Surgery","volume":"31","author":"Kohler","year":"2019","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2320","DOI":"10.1177\/00031348211023428","article-title":"Leveraging Collaboration in Pediatric Multidisciplinary Colorectal Care Using a Telehealth Platform","volume":"88","author":"Lopez","year":"2022","journal-title":"Am. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/0142159X.2021.1880558","article-title":"Twelve Tips for Clinical Teaching with Telemedicine Visits","volume":"44","author":"Hovaguimian","year":"2022","journal-title":"Med. Teach."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1776","DOI":"10.1016\/j.jpedsurg.2015.06.005","article-title":"The Burden of Attending a Pediatric Surgical Clinic and Family Preference toward Telemedicine","volume":"50","author":"Bator","year":"2015","journal-title":"J. Pediatr. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1016\/j.jpedsurg.2022.10.008","article-title":"The Cost Impact of Telehealth Interventions in Pediatric Surgical Specialties: A Systematic Review","volume":"58","author":"Jungbauer","year":"2023","journal-title":"J. Pediatr. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.jpedsurg.2018.06.018","article-title":"Delayed Access to Care and Unmet Burden of Pediatric Surgical Disease in Resource-Constrained African Countries","volume":"54","author":"Yousef","year":"2019","journal-title":"J. Pediatr. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1002\/bdr2.2129","article-title":"Prevalence and Mortality among Children with Anorectal Malformation: A multi-country Analysis","volume":"115","author":"Kancherla","year":"2023","journal-title":"Birth Defects Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1007\/s12098-021-03887-2","article-title":"Anorectal Malformations: The Earlier the Diagnosis, the Better the Outcome","volume":"89","author":"Reddy","year":"2022","journal-title":"Indian J. Pediatr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1016\/j.jpedsurg.2018.07.019","article-title":"Patterns and Treatment Outcomes of Anorectal Malformations in Mbarara Regional Referral Hospital, Uganda","volume":"54","author":"Kayima","year":"2019","journal-title":"J. Pediatr. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1016\/j.jpedsurg.2016.07.018","article-title":"A Standardized Approach for the Assessment and Treatment of Internationally Adopted Children with a Previously Repaired Anorectal Malformation (ARM)","volume":"51","author":"Lane","year":"2016","journal-title":"J. Pediatr. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1016\/j.jpedsurg.2022.03.015","article-title":"Both Sides of the Screen: Provider and Patient Perspective on Telemedicine in Pediatric Surgery","volume":"57","author":"Knaus","year":"2022","journal-title":"J. Pediatr. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1007\/s00383-021-04971-6","article-title":"Children with Congenital Colorectal Malformations during the UK SARS-CoV-2 Pandemic Lockdown: An Assessment of Telemedicine and Impact on Health","volume":"37","author":"Stathopoulos","year":"2021","journal-title":"Pediatr. Surg. Int."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/j.jpedsurg.2022.01.048","article-title":"The Utilization of Telehealth during the COVID-19 Pandemic: An American Pediatric Surgical Association Survey","volume":"57","author":"Shah","year":"2022","journal-title":"J. Pediatr. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1007\/s00383-009-2502-z","article-title":"Bowel Management for the Treatment of Pediatric Fecal Incontinence","volume":"25","author":"Bischoff","year":"2009","journal-title":"Pediatr. Surg. Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1016\/j.jpedsurg.2013.10.022","article-title":"Bowel Symptoms in Children with Anorectal Malformation\u2014A Follow-up with a Gender and Age Perspective","volume":"49","author":"Kockum","year":"2014","journal-title":"J. Pediatr. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2071","DOI":"10.1016\/j.jpedsurg.2007.08.033","article-title":"A Comparative Study of Laparoscopy-Assisted Pull-through and Open Pull-through for Hirschsprung\u2019s Disease with Special Reference to Postoperative Fecal Continence","volume":"42","author":"Fujiwara","year":"2007","journal-title":"J. Pediatr. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1007\/s00383-016-3908-z","article-title":"Long-Term Results of Transanal Pull-through for Hirschsprung\u2019s Disease: A Meta-Analysis","volume":"32","author":"Zimmer","year":"2016","journal-title":"Pediatr. Surg. Int."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.jpedsurg.2018.04.019","article-title":"A Descriptive Model for a Multidisciplinary Unit for Colorectal and Pelvic Malformations","volume":"54","author":"Halleran","year":"2019","journal-title":"J. Pediatr. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"150985","DOI":"10.1016\/j.sempedsurg.2020.150985","article-title":"Creating a Collaborative Program for the Care of Children with Colorectal and Pelvic Problems","volume":"29","author":"Choueiki","year":"2020","journal-title":"Semin. Pediatr. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1016\/j.jpedsurg.2020.05.002","article-title":"Development of a Multidisciplinary Colorectal and Pelvic Health Program: Program Implementation and Clinical Impact","volume":"55","author":"Style","year":"2020","journal-title":"J. Pediatr. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1007\/s00383-016-3909-y","article-title":"Critical Analysis of Fecal Incontinence Scores","volume":"32","author":"Bischoff","year":"2016","journal-title":"Pediatr. Surg. Int."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Bokova, E., Svetanoff, W.J., Levitt, M.A., and Rentea, R.M. (2023). Pediatric Bowel Management Options and Organizational Aspects. Children, 10.","DOI":"10.3390\/children10040633"},{"key":"ref_44","unstructured":"(2024, June 23). Rome IV Criteria. Available online: https:\/\/theromefoundation.org\/rome-iv\/rome-iv-criteria\/."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1016\/j.jpedsurg.2018.02.076","article-title":"Initial Development and Validation of a Fecal Incontinence-Specific Quality of Life Measure","volume":"53","author":"Cushing","year":"2018","journal-title":"J. Pediatr. Surg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.jpedsurg.2019.10.062","article-title":"Intermediate and Long-Term Outcomes of a Bowel Management Program for Children with Severe Constipation or Fecal Incontinence","volume":"55","author":"Kilpatrick","year":"2020","journal-title":"J. Pediatr. Surg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1016\/j.jpedsurg.2021.04.025","article-title":"Prospective Quality of Life Outcomes in Pediatric Fecal Incontinence Following Bowel Management","volume":"56","author":"Lim","year":"2021","journal-title":"J. Pediatr. Surg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1001\/jamapediatrics.2014.1600","article-title":"Validity and Responsiveness of the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales in the Pediatric Inpatient Setting","volume":"168","author":"Desai","year":"2014","journal-title":"JAMA Pediatr."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/1477-7525-3-34","article-title":"Health-Related Quality of Life Measurement in Pediatric Clinical Practice: An Appraisal and Precept for Future Research and Application","volume":"3","author":"Varni","year":"2005","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1111\/j.1524-4733.2007.00293.x","article-title":"Health-Related Quality of Life Measurement in Children and Adolescents: A Systematic Review of Generic and Disease-Specific Instruments","volume":"11","author":"Solans","year":"2008","journal-title":"Value Health"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Pe\u00f1a, A., and Bischoff, A. (2015). Surgical Treatment of Colorectal Problems in Children, Springer International Publishing.","DOI":"10.1007\/978-3-319-14989-9"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.jpedsurg.2019.10.048","article-title":"Quality of Life in Children with Pseudoincontinence after Implementing a Bowel Management Program in Egypt","volume":"55","author":"Gabr","year":"2020","journal-title":"J. Pediatr. Surg."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e34","DOI":"10.1097\/MPG.0000000000002348","article-title":"Development of a Patient-Reported Experience and Outcome Measures in Pediatric Patients Undergoing Bowel Management for Constipation and Fecal Incontinence","volume":"69","author":"Halleran","year":"2019","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1046\/j.1365-2710.2001.00363.x","article-title":"Patient Adherence to Treatment: Three Decades of Research. A Comprehensive Review","volume":"26","author":"Vermeire","year":"2001","journal-title":"J. Clin. Pharm. Ther."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2471","DOI":"10.1007\/s00381-018-3860-4","article-title":"Short versus Mid-Long-Term Outcome of Transanal Irrigation in Children with Spina Bifida and Anorectal Malformations","volume":"34","author":"Ausili","year":"2018","journal-title":"Childs Nerv. Syst."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1097\/MPG.0000000000000974","article-title":"Follow-up in Childhood Functional Constipation: A Randomized, Controlled Clinical Trial","volume":"62","author":"Modin","year":"2016","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.urology.2023.06.006","article-title":"Personalized Pre-Clinic Nursing Telemedicine Visit: An Efficient and Efficacious Approach for Bowel and Bladder Dysfunction in Children","volume":"179","author":"Finup","year":"2023","journal-title":"Urology"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/7\/786\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:06:39Z","timestamp":1760108799000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/7\/786"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,27]]},"references-count":57,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["children11070786"],"URL":"https:\/\/doi.org\/10.3390\/children11070786","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,27]]}}}