Perineal canal ? repair by a new surgical technique

“Perineal Canal”: A Rare Anorectal Malformation of Variable Complexity

“…The incidence is apparently variable, since some relatively large series have been reported from Asia [13] with very few cases from other countries. Several authors have suggested that PC might be acquired after perineal infection [6,10]. However, there is no doubt that the histology and the anatomical patterns of most documented cases and of our own are consistent with a malformative mechanism in which excessive fusion of the ectoderm and mesenchym of the genital folds and perineum and sometimes abnormal Müllerian confluence at the cloacal region are involved [1,10].…”

“…The fact that our only case with supralevator rectal agenesis (patient 3) had vertebral and renal malformations further reinforces this concept. Immediate repair by simply opening the PC with or without excision of the remaining mucosa [2,4,6] or perineal fistulectomy [4,10 -12] are probably the best approaches in most of the simpler cases, but whenever in doubt about the anatomy, a sigmoidostomy should be performed in order to allow for a more accurate diagnosis and planning of a more appropriate surgical approach [3, 4, 7,11 -13]. The operation itself cannot be considered a simple one [2], at least in some cases.…”

Anovestibular fistula with normal anal opening: Is it always congenital?

“…Various surgical approaches like vestibule-anal pull through,[ 2 ] pull through of the anterior rectal wall,[ 10 ] limited perineal PSARP,[ 15 ] endorectal pull through, and direct excision[ 16 ] have been described to eradicate the fistula. The procedure can be combined[ 10 ] with colostomy.…”

Labial flap: a versatile tool in the repair of recurrent perineal canal defects

“…The perineal canal, or anorectal-vestibular fistula without imperforate anus is an anomaly more frequently seen in Asian countries [1,2]. Although a congenital origin is proposed [3,4], the fact that this lesion is often seen associated with local suppuration requiring an initial colostomy, and also that spontaneous cures are seen after a diverting colostomy, support an acquired etiology [1].…”

“…Although a congenital origin is proposed [3,4], the fact that this lesion is often seen associated with local suppuration requiring an initial colostomy, and also that spontaneous cures are seen after a diverting colostomy, support an acquired etiology [1]. The standard surgical treatment is to dissect out the track, invert it into the rectum and repair the defect (vestibulo-anal pull through) [3].…”