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ORIGINAL ARTICLE
Year : 2015  |  Volume : 28  |  Issue : 4  |  Page : 813-817

Primary versus multistage repair of congenital rectovestibular fistula


Department of General Surgery, Faculty of Medicine, Menoufia University, Menofia Governorate; Department of Pediatric Surgery, Ministry of Health, Kafr ELzayat, Gharbia, Egypt

Correspondence Address:
Wael Omar Zeina
Kafr ELzayat, Gharbia, 31611
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.173597

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Objective The aim of this study was to evaluate the feasibility, safety, and outcome of one-stage posterior sagittal anorectoplasty in cases of rectovestibular fistula. Background Rectovestibular fistula is the most common type of anorectal malformation in the female population. The standard treatment for rectovestibular fistula is the staged approach. In recent times, posterior sagittal anorectoplasty has revolutionized the management of anorectal malformation (ARMs). Materials and methods This study was conducted on 24 female patients with rectovestibular fistula who were divided into two groups: Group 1: This group comprised patients who underwent primary repair without colostomy (14 cases) prospectively. Group 2: This group comprised patients who underwent multistage repair (10 cases) retrospectively (the last 10 cases were operated upon in our hospital). Results A total of 24 patients were included in our study. All patients were more than 1 month old. Intraoperative complications included opening the posterior wall of the vagina (n = 2). Postoperative complications included the following: anal excoriations in seven patients in group 1 only; superficial wound inflammation in four patients in group 1 but only in one patient in group 2; partial dehiscence of the perineal skin in three patients in group 1 but only in one patient in group 2; anal stenosis in one patient in each group; and mucosal prolapse in one patient in group 1 only. Conclusion Primary repair of rectovestibular fistula is technically feasible and safe. It avoids the risk of complications related to colostomy and the risks of multiple anesthesia, and reduces the economic and psychological burden on the family.


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