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318 Chapter 16 METHODS Study subjects This study was performed at a tertiary center for children with defecation disorders (Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands). Children (age 0–18 years) who received surgical interventions for FC between January 2010 and June 2015 were identified retrospectively. Prior to undergoing surgery, all children met the criteria for FC as defined by the Rome III criteria 18 and suffered from intractable constipation, defined as failure to respond to intensive conventional therapy for ≥3 months as described in the ESPGHAN-NASPGHAN guidelines for FC. 2 Patients with organic causes of constipation were excluded. Surgical interventions were categorized as: (i) ileostomy; (ii) colostomy and; (iii) (sub)total colectomy. Patients who had solely received anal botox injections, SNS, appendicocecostomy (also referred to as ‘Malone’) or Chait ®  cecostomy were excluded. Parents of all eligible patients were approached via telephone to answer a questionnaire. Informed consent was provided over the telephone. The study protocol was approved by the medical ethics committee of the Academic Medical Center. Retrospective chart review Clinical characteristics regarding the medical history before surgery were collected through chart reviews. These data included demographics, constipation-associated symptoms, duration of symptoms, treatment prior to surgery and the preoperative diagnostic evaluation. In addition, data regarding the operation and postsurgical follow-up were obtained, including the type of operation, occurrence of complications and subsequent reoperations. Complications were classified as per the Clavien-Dindo classification 19 , which is based on the type of therapy that is required to treat the complication. Questionnaire Questionnaires developed by our teamwere administered to parents over the telephone by two authors (S.K.W or L.W.Z.) who were not involved in the initial evaluation and treatment of the child. If possible, parents were asked to answer the questions together with their children. Postsurgical health-related problems and satisfaction about the surgery were assessed together with current bowel habits, constipation-associated symptoms according to the Rome III criteria, abdominal pain, school absences, and currentmedications.Treatment success was defined as no longer fulfilling the Rome III criteria for FC in patients after stoma closure or as having a functional ostomy in children with an ileostomy or colostomy, independent of pharmacological treatment. Parental satisfaction after surgical treatment