Repair of low anorectal anomalies in female patients

Allam, Ayman M.; Zeid, Amr A. Abou; Shafei, Ihab El; Ghanem, Wael; Albaghdady, Ayman

doi:10.1097/01.xps.0000508435.98985.a2

Cited by 9 publications

(8 citation statements)

References 15 publications

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“…Wound dehiscence at the mucocutaneous junction after sagittal anorectoplasty is a common complication [9,22], that may lead to delayed functional sequelae (constipation and soiling) [16]. However, in this study we could not find significant correlation between the occurrence of wound dehiscence and delayed functional sequelae.…”

Section: Discussioncontrasting

confidence: 73%

Role of sagittal anorectoplasty in treating constipation in patients with recto-perineal fistula

2020

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Background: Recto-perineal fistula is a common anorectal anomaly, affecting both males and females. The anus is abnormally anteriorly located and is usually stenotic. Management of recto-perineal fistula is a dialectic problem. The most common presenting complaint is constipation; also, long-term follow-up of these patients revealed high incidence of postoperative constipation. Results: The study included 30 patients (19 female and 11 male). Their age at time of repair ranged from 3 to 78 months. We compared the pre-and postoperative constipation rate after limited posterior sagittal anorectoplasty (PSARP) using Krickenbeck score. Overall, the rate of constipation has dropped from 77 (23/30) to 30% (9/30) after surgery. Fourteen patients out of 23 patients with preoperative constipation were cured. Another patient with preoperative constipation improved regarding the grade of constipation. The remaining 8 patients with preoperative constipation did not show improvement after operation. These results were statistically significant (McNemar test). Out of the 9 patients who were still constipated after surgery, 7 had associated fecal soiling that showed good response with bowel management of constipation. Conclusion: Limited posterior sagittal anorectoplasty can have a role in treating constipation among cases of recto-perineal fistula.

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Section: Discussioncontrasting

confidence: 73%

Role of sagittal anorectoplasty in treating constipation in patients with recto-perineal fistula

2020

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“…Different PO oral allowances have been described. From oral feeding on the 1 st PO Day [19,38], after 24 hours [40], to delaying feeding to the 3 rd day [37,41], the 4th day [36], or to the 5th day [21,22,42,43].…”

Section: Discussionmentioning

confidence: 99%

One Stage Anterior Sagittal Sphincter Saving Anorectoplasty (ASSSARP) for the Repair or Rectovestibular Fistula: Mid and Long-term Outcome in Two Tertiary Centers.

Elbatarny,

Shehata,

Ashour

et al. 2024

Preprint

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Purpose This is a retrospective study of 1-stage ASSSARP for RVF including operative details and postoperative complications, functional and cosmetic outcome. Patients and Methods: Records of 41 cases of RVF, managed between April 2010 and September 2019 by one-stage ASSSARP, were reviewed. Preoperative preparation, both early and late postoperative care & complications, hospital stay, and functional & cosmetic outcomes were reported. Results The mean age was 6.6 months. Vaginal tear 5/41 cases, and distal rectal tears 4/41 cases. Mild superficial wound inflammation; 13 patients, Skin dehiscence; 5 patients. No colostomy or redo was needed. The mean hospital stay was 6.1 days. Mean follow-up was 43.13 months; (Range; 24–100 months). Anal stricture; 6 patients. constipation occurred in 14 cases. Soiling grade I occurred in 5 patients. 32 patients > 3 years; 2 patients showed cough/diarrhea incontinence. Conclusion One-stage ASSSARP is safe and gives functional and cosmetic results comparable to other techniques. It provides better access to female anomalies. The avoidance of muscle incision protects against muscle breakdown, if infection sets in, and thus against incontinence. It avoids the morbidity, cost and psychological burden of performing a 3-stage repair.

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“…The wound infection and wound dehiscence may comprise the expected good functional outcome in this type of malformation. A large number of authors have preferred two stage repair of congenital rectovestibular fistula 5,[8][9][10]19 .…”

Section: Discussionmentioning

confidence: 99%

“…9 Presence of protective colostomy is associated with good functional outcome of the management of recto-vestibular fistula. 10 However the colostomy has its own problems which are not tolerated well by children and their parents 11,12 .…”

Section: Introductionmentioning

confidence: 99%

The Outcome of Single Stage versus Two Stage Repair in Anorectal Malformations with Recto-Vestibular Fistula

Rehman¹,

Haq²,

Fazal³

et al. 2022

PJMHS

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Background: Imperforate anus with recto-vestibular fistula is one of the most common anorectal malformations in females. Wound infection and disruption after recto-vestibular fistula repair may affect the fecal continence and functional outcome. Fecal incontinence may cause long term social, economical and psychological problems in children. Although a protective colostomy reduces the infectious complications and dehiscence, it is also associated with many problems. Aim: To compare the safety, feasibility, post operative complications and functional outcomes of limited posterior sagittal anorectoplasty with or without colostomy. Study design: Prospective descriptive study. Place and duration of sudy: Department of Pediatric Surgery, Sahiwal Teaching Hospital Sahiwal, from 1st January 2019 to 31st December 2021. Methodology: Forty-one patients with congenital recto-vestibular fistula were managed by two techniques. Patients were divided into two groups. Group A (19 patients): were operated by single stage limited posterior sagittal anorectoplasty without covering colostomy. Group B (22 patients): were operated by two stage technique. Limited posterior sagittal anorectoplasty and covering colostomy in first stage and stoma closure was done in second stage. The patients in both groups were evaluated for hospital stay, operation time, postoperative complications, fecal continence, constipation, bowel function. Results: The age of patients ranged from 11-56 months (mean 26.93 months) in Group A and 9-60 months (mean 27.03 months) in Group B. The total length of hospital stay in Group A ranged from 7-11 days (mean 9.20 days); however, in Group B, it ranged from 4-6 days (mean 5.01 days) for first stage procedure and 8-11 days (mean 9.27 days) for second stage colostomy closure procedure. In Group A, complications were, wound infection 03 (15.78%), anal stenosis 02 (10.52%), mucosal prolapse 01 (5.26%), constipation 04 (21.05%), soiling 04 (21.05%), perineal excoriation 03 (15.78%) and recurrent H-type recto-vestibular fistula 01 (5.26%). In Group B, during the first stage of repair, one patient (4.54%) developed wound infection. Mucosal prolapse was observed in one patient (4.54%). Constipation was reported in 03 (13.63%) and soiling in 01 (4.54%). Peri stoma skin excoriation was seen in five patients (22.72%). Stomal prolapse was observed in two patients (9.09%). Two patients (9.09%) developed wound infection after colostomy closure. Conclusion: Single stage repair of congenital recto-vestibular fistula increases the risk of postoperative complications. Two stage approach is associated with less postoperative complications. However it is associated with lengthy hospital stay, long operation time and complications related to stoma formation and closure. Keywords: Recto-vestibular fistula, Limited posterior sagittal anorectoplasty, Single stage technique, Two stage technique.

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Repair of low anorectal anomalies in female patients

Cited by 9 publications

References 15 publications

Role of sagittal anorectoplasty in treating constipation in patients with recto-perineal fistula

Role of sagittal anorectoplasty in treating constipation in patients with recto-perineal fistula

One Stage Anterior Sagittal Sphincter Saving Anorectoplasty (ASSSARP) for the Repair or Rectovestibular Fistula: Mid and Long-term Outcome in Two Tertiary Centers.

The Outcome of Single Stage versus Two Stage Repair in Anorectal Malformations with Recto-Vestibular Fistula

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