Modified transanal repair of congenital H-type rectovestibular fistula: A technique to avoid recurrence

Lawal, Taiwo A.; Eighemhenrio, Aiwanlehi; Kumolalo, Felix O.

doi:10.4103/0189-6725.109393

Cited by 8 publications

(4 citation statements)

References 8 publications

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“…Delayed diagnosis beyond 24–48 h of birth is unusual in developed countries because of adherence to guidelines on newborn care since most deliveries are supervised. There may also be delay in diagnosis when the malformation is subtle or a rare variant such as H-type fistula is encountered (52, 53). Furthermore, extreme delays beyond childhood are uncommon except in low resource settings such as in many developing countries.…”

Section: Presentation Outside the Neonatal Periodmentioning

confidence: 99%

Overview of Anorectal Malformations in Africa

Lawal

2019

Front. Surg.

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Anorectal malformation is one of the most common structural congenital malformations treated by pediatric surgeons globally. The outcome of care is largely dependent on the spectrum, clinical features, associated malformations, expertise of the surgeons, and available perioperative facilities. Africa has a large burden of unmet surgical needs in children, and as in other low resource settings, local pediatric surgeons are faced with different and challenging clinical scenarios, hence, adopt various measures to enable children with surgically correctable congenital malformations to survive. There are increasing collaborations between local surgeons and experts in other continents, which often involves surgeons traveling to Africa on missions or well-structured partnerships. It is highly beneficial for the physician who is interested in global-surgery to understand the terrain in low resource settings and prepare for possible changes in management plan. This review highlights the epidemiology, clinical presentation, treatment, and outcome of care of children with anorectal malformations in Africa and provides options adopted by pediatric surgeons working with limited resources.

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Section: Presentation Outside the Neonatal Periodmentioning

confidence: 99%

Overview of Anorectal Malformations in Africa

Lawal

2019

Front. Surg.

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“…The anterior perineal and transanal approaches are the two most commonly employed for this condition [7][8][9][10][11]. However, no matter which approach is used, fistulotomy or seton therapy must never be considered, because they can cause severe a rectovestibular disruption defect [5] (Fig.…”

Section: Discussionmentioning

confidence: 98%

“…In addition, this surgery would not cause sphincter injury as the transanal approach may be because of anal overtraction. The biggest advantage of transanal approach is no perineal incision, which can preserve the normal appearance and intactness of perineum to the utmost [10].…”

Section: Discussionmentioning

confidence: 99%

Anterior perineal fistulectomy in repairing H-type rectovestibular fistula with a normal anus in female children

Wang¹,

Chen²,

Zhang³

et al. 2015

Journal of Pediatric Surgery

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The purpose of this study was to review a 7-year operative experience of anterior perineal fistulectomy in repairing H-type rectovestibular fistula with a normal anus in female children. From January 2007 to December 2013, 105 female children with H-type rectovestibular fistula and a normal anus underwent anterior perineal fistulectomy in the Department of General Surgery, Beijing Children's Hospital, Capital Medical University. Clinical data were retrospectively analyzed. Patients' age ranged from 6 months to 13 years 10 months, with an average age 5 years 2 months. The clinical feature of this disease was a definite history of vestibular infection at about 30 days after birth and leakage of gas or loose stool through vestibular fistular orifice after the infection was controlled. All patients had a normal anus. Follow-up through telephone or outpatient visits from 6 months to 7 years (median, 5.2 years), showed that all the patients were continent and had regular bowel movements. Among the 105 patients, 97 (92.4%) gained primary healing with a satisfactory appearance; 8 (7.6%) patients relapsed, among which 5 healed after hip bathing treatment within 3 weeks, 2 required another anterior perineal fistulectomy 7 months later and were cured, and the last one had another anterior perineal fistulectomy 1 year 10 months later but relapsed again, which healed after hip bathing treatment within 3weeks after the second surgery. Anterior perineal fistulectomy is a simple, safe and reliable surgical method to treat H-type rectovestibular fistula with a normal anus.

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“…He reported 12 cases, and in 7 cases he performed this technique and none of them relapsed. After that, Lawal et al 3,13 and Akhparov et al 5 used the same technique. They reported 27 cases without recurrence.…”

Section: Discussionmentioning

confidence: 99%

The Surgical Management of H-Type Rectovestibular Fistula: A Novel Modification

Wang

et al. 2015

Eur J Pediatr Surg

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Introduction H-type rectovestibular fistulas could be rare anorectal malformations or acquired diseases secondary to perianal infection. Various surgical procedures have been described in the literature, however the problem of recurrence still remains to be solved. We describe a novel modified surgical procedure and outcome in the management of these patients. Methods From 1999 to 2014, 14 patients who had an H-type rectovestibular fistula underwent the same surgical procedure performed by the same surgical team. Rectal-vestibular pull-through inside-out and endorectal mucosal advancement flap was used, including circumferential incision of the fistula from the opening on the rectal side, pulling the fistula inside-out, ligating the fistula, and mobilizing a rectal mucosal flap to cover the internal opening. Results All the patients have been followed-up for 12 months to 15 years with no recurrences and no incontinence. Conclusion Our surgical management is a simple, safe, and probable choice for the treatment of H-type rectovestibular fistula with favorable outcomes.

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Modified transanal repair of congenital H-type rectovestibular fistula: A technique to avoid recurrence

Cited by 8 publications

References 8 publications

Overview of Anorectal Malformations in Africa

Overview of Anorectal Malformations in Africa

Anterior perineal fistulectomy in repairing H-type rectovestibular fistula with a normal anus in female children

The Surgical Management of H-Type Rectovestibular Fistula: A Novel Modification

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