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eHealth in Pediatric Surgery : Impact on Postsurgical Care After Reconstructive Surgery for Anorectal Malformations and Hirschsprung's Disease

Wester Fleur, Matilda LU orcid ; Johnsson, Björn A. LU orcid ; Castor, Charlotte LU and Stenström, Pernilla LU orcid (2025) In Journal of Pediatric Surgery 60(5).
Abstract

Background: To support care after discharge following surgery for anorectal malformations (ARM) and Hirschsprung's disease (HD), an eHealth device was invented, offering families bilateral communication through chat, photo, questionaries and video. Aim: To explore the impact of eHealth on postoperative patterns of expert consultation, complications and treatment after discharge following surgery for ARM and HD, respectively, compared to conventional care. Method: Interventional prospective case control study observing postoperative care 30 days after discharge after ARM and HD-reconstructions July 2018–July 2023, comparing outcomes between families using the eHealth device versus conventional care. Results: Consecutively included were... (More)

Background: To support care after discharge following surgery for anorectal malformations (ARM) and Hirschsprung's disease (HD), an eHealth device was invented, offering families bilateral communication through chat, photo, questionaries and video. Aim: To explore the impact of eHealth on postoperative patterns of expert consultation, complications and treatment after discharge following surgery for ARM and HD, respectively, compared to conventional care. Method: Interventional prospective case control study observing postoperative care 30 days after discharge after ARM and HD-reconstructions July 2018–July 2023, comparing outcomes between families using the eHealth device versus conventional care. Results: Consecutively included were 95/141 families (eHealth: ARM n = 48, HD n = 25; respective conventional care: ARM n = 16, HD n = 6). Days to first contact after discharge were fewer for eHealth users, both for ARM 2 vs. 5.5 (p = 0.000) and HD 1 vs 7 (p = 0.000). Days with consultations were more numerous using eHealth: ARM 9 vs 4 (p = 0.000) and HD 12 vs 3.5 (p = 0.001) specifically nurse counseling; ARM 6 versus 1 (p = 0.000) and HD 11 vs 2.5 (p = 0.001). In ARM patients the complication frequency was 23 % (eHealth) versus 50 % (conventional), and the complication severity was lower: Clavien-Madadi 0 (0–4) versus 1 (0–3) (p = 0.040). Treatment adjustments were more frequent for HD patients using eHealth (3 vs. 2 (p = 0.041)). Conclusion: Use of eHealth after ARM respective HD reconstructions implies earlier and more frequent postoperative counseling, especially with nurses. When using eHealth complications were less severe in ARM-patients and treatment adjustments more frequent in the HD patients, compared to those under conventional care.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Anorectal malformations, Communication, eHealth, Hirschsprung's disease, Pediatric surgery, Postoperative care
in
Journal of Pediatric Surgery
volume
60
issue
5
article number
162251
publisher
Elsevier
external identifiers
  • scopus:85218850986
  • pmid:40023105
ISSN
0022-3468
DOI
10.1016/j.jpedsurg.2025.162251
project
Tablets as part of e-health - a safe bridge between the hospital and the home of the newly operated child?
language
English
LU publication?
yes
id
f3e7591a-e311-48ba-a067-23860857cbde
date added to LUP
2025-06-12 10:52:04
date last changed
2025-10-16 23:26:54
@article{f3e7591a-e311-48ba-a067-23860857cbde,
  abstract     = {{<p>Background: To support care after discharge following surgery for anorectal malformations (ARM) and Hirschsprung's disease (HD), an eHealth device was invented, offering families bilateral communication through chat, photo, questionaries and video. Aim: To explore the impact of eHealth on postoperative patterns of expert consultation, complications and treatment after discharge following surgery for ARM and HD, respectively, compared to conventional care. Method: Interventional prospective case control study observing postoperative care 30 days after discharge after ARM and HD-reconstructions July 2018–July 2023, comparing outcomes between families using the eHealth device versus conventional care. Results: Consecutively included were 95/141 families (eHealth: ARM n = 48, HD n = 25; respective conventional care: ARM n = 16, HD n = 6). Days to first contact after discharge were fewer for eHealth users, both for ARM 2 vs. 5.5 (p = 0.000) and HD 1 vs 7 (p = 0.000). Days with consultations were more numerous using eHealth: ARM 9 vs 4 (p = 0.000) and HD 12 vs 3.5 (p = 0.001) specifically nurse counseling; ARM 6 versus 1 (p = 0.000) and HD 11 vs 2.5 (p = 0.001). In ARM patients the complication frequency was 23 % (eHealth) versus 50 % (conventional), and the complication severity was lower: Clavien-Madadi 0 (0–4) versus 1 (0–3) (p = 0.040). Treatment adjustments were more frequent for HD patients using eHealth (3 vs. 2 (p = 0.041)). Conclusion: Use of eHealth after ARM respective HD reconstructions implies earlier and more frequent postoperative counseling, especially with nurses. When using eHealth complications were less severe in ARM-patients and treatment adjustments more frequent in the HD patients, compared to those under conventional care.</p>}},
  author       = {{Wester Fleur, Matilda and Johnsson, Björn A. and Castor, Charlotte and Stenström, Pernilla}},
  issn         = {{0022-3468}},
  keywords     = {{Anorectal malformations; Communication; eHealth; Hirschsprung's disease; Pediatric surgery; Postoperative care}},
  language     = {{eng}},
  number       = {{5}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Pediatric Surgery}},
  title        = {{eHealth in Pediatric Surgery : Impact on Postsurgical Care After Reconstructive Surgery for Anorectal Malformations and Hirschsprung's Disease}},
  url          = {{http://dx.doi.org/10.1016/j.jpedsurg.2025.162251}},
  doi          = {{10.1016/j.jpedsurg.2025.162251}},
  volume       = {{60}},
  year         = {{2025}},
}