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

Abstract

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

Rectovestibular fistula with normal anus: a simple resection or an extensive perineal dissection?

“…Other investigators believe that it is an acquired condition [9][10][11][12]. Sun et al [13] compared the histologic findings in a group of 19 patients with fistula and a normal anus to another group of 10 having a fistula associated with imperforate anus and suggested that most RVFNA originated from a vulvar abscess.…”

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

“…This condition does not interfere with development and growth, and daily life inconvenience is also rare. Therefore the main reason for surgery is often psychological, which leads to high expectations from patients and parents for the surgery [5].…”

“…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. 5).…”

Acquired Rectovaginal Fistula in Babies of Unknown and Asymptomatic Retroviral Positive Mothers

“…Also, earlier authors reported rectovestibular disruption following the repair of acquired rectogenital fistula. 9 We placed a 2cm transverse incision between the anus and vagina which was carefully dissected until the fistula was identified and excised. The rectal and vaginal defects were repaired in two layers and the wound closed in layers by careful tissues apposition.…”