Primary Anterior Sagittal Anorectoplasty for Rectovestibular Fistula

Aziz, Abdul; Prasad, Ramanandan; Khan, Abdur Rashed; Banu, Tahmina

doi:10.1016/s1015-9584(09)60288-8

Cited by 29 publications

(35 citation statements)

References 8 publications

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“…(8,9) Various surgeons have reported that there is no significant difference in multistage and single stage procedure. (10)(11)(12)(13)(14)(15)(16)(17) Our series is small for statistical analysis, but the results are in accordance with these reported series outcome in terms of continence can be achieved by careful anterior sagittal surgical dissection. Anovestibular fistula can be repaired in one stage with meticulous pre-and postoperative bowel management.…”

Section: Discussionsupporting

confidence: 83%

Anorectal Malformation Female Children One Stage Procedure Asarp

Shrivastava¹

2016

jemds

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CONTEXTAnorectal malformation is a common congenital defect in children and its management has evolved over the years. Anterior sagittal approach is established as a popular technique for the correction of anovestibular fistula in children with anorectal malformations due to advancement of technology magnification, muscle stimulation and precise placement of the anal canal within the external sphincter complex. AIMSTo study the outcome of anterior sagittal approach as single stage procedure for anorectal malformations in female children at tertiary care centre. SETTINGS AND DESIGNPaediatric Surgery Department, Gandhi Medical College, Bhopal. A retrospective analysis. METHODS24 female patients with congenital anorectal malformation who underwent Anterior Sagittal Anorectoplasty (ASARP) as a single stage procedure were reviewed. The surgical procedure and its outcome were evaluated. RESULTSThere was no case that had significant haemorrhage during or after procedure; 4 cases had rent in the posterior vaginal wall which was managed adequately due to early detection. There were six cases with wound infection. One case had dehiscence; three cases developed constipation, which was managed with dilation and bowel training. CONCLUSIONASARP as a single stage procedure without colostomy cover should be considered as a preferable option for the management of anovestibular fistula in female children.

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Section: Discussionsupporting

confidence: 83%

Anorectal Malformation Female Children One Stage Procedure Asarp

Shrivastava¹

2016

jemds

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“…With anterior perineal anorectoplasty conventionally used for imperforated anus, and rectovestibular fistula with normal anus [10][11][12] , we recommand it here for rectovestibular disr uption (RVD). It provided a good exposure of operation field to separate the rectovaginal septum, and to find the broken ends of sphincter ani externus for reunion.…”

Section: Discussionmentioning

confidence: 99%

Recto-vestibular disruption defect resulted from the malpractice in the treatment of the acquired recto-vestibular fistula in infants

Zhang

Pang²,

Chen³

et al. 2007

WJG

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AIM:To explore the pathogenesis of the rectovestibular disruption (RVD) defect and to recommend a successful repair, and prevention of it. METHODS:Clinical records of 15 girls, age ranged from 3 to 15 (median, 7.5) years, with acquired rectovestibular fistula (RVF) mistreated before were retrospectively reviewed. All of them presented an abnormal appearance of perineum and were suffering from some degree of fecal incontinence, and those were graded Ⅲ to Ⅳ by Li Zheng's Score. Repair of anal sphincters and reconstruction of perineum body and skin by anterior perineal rectoanoplasty were performed in all cases. RESULTS:Operation in all cases was successful. The perineum looked practically normal and fecal continence score rose up to VI by Li Zheng's Score. CONCLUSION:T h e c o n v e n t i o n a l t r e a t m e n t f o r anal fistula, lay-open or string-treatment, should be considered as malpractice of RVF, and certainly leads to the RVD defect, and the anterior perineal rectoanoplasty could cure it satisfactorily.© 2007 The WJG Press. All rights reserved.Key words: Rectovestibular fistula; Acquired; Disruption; Children Zhang TC, Pang WB, Chen YJ, Zhang JZ. Recto-vestibular disruption defect resulted from the malpractice in the treatment of the acquired recto-vestibular fistula in infants.World

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“…The infection rate for ASARP is 22% in this series, higher than previous series. 24,37,45 However, the reported wound breakdown in the ASARP group involving the perineal body is only for the first two cases, probably reflecting the learning curve of the surgeon during the initial stages. They were managed conservatively with therapeutic antibiotics for 1 week and 3 hourly with normal saline flushing for a week.…”

Section: Early Surgical Outcomementioning

confidence: 99%

“…37 Early repair prevents the loss of cortical integration of somatosensory input from anal skin and enhances the development of normal stooling patterns at the appropriate time. [38][39][40] Traditionally, postoperative neoanal dilatation is a routine practice among pediatric surgeons to avoid anocutaneous stricture and to ensure a patent anus prior to closure of colostomy.…”

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confidence: 99%