Original articleSingle-stage repair of vestibular and perineal fistulae without colostomy
Section snippets
Aim and objectives
This retrospective study was undertaken to evaluate the feasibility of primary anorectoplasty without a covering colostomy in patients having vestibular and perineal fistulae, either by the anterior sagittal anorectoplasty (ASARP) or the posterior sagittal anorectoplasty (PSARP) technique. The short- and long-term complications, results, and remote outcome of these techniques (ASARP or PSARP) in our institute have been mentioned for single-stage repair of vestibular and perineal fistulae. We
Material and method
The hospital records of all the patients with vestibular and perineal fistulae subjected to single-stage surgical correction either by ASARP or PSARP at our institute during January 2000 to June 2007 were evaluated retrospectively. All patients were assessed for immediate and delayed complications including continence of the neorectum. The classification of anomaly is based on the Krinkenbeck Conference [1] on ARM in 2005.
Discussion
Anorectal malformations (ARM) constitute the most varied group of congenital defects. They affect approximately 1 in 3500 live births [2]. Vestibular fistula is the most common form of ARM in girls and is associated with the best prognosis. It is estimated that 93% of patients with vestibular fistula will develop voluntary bowel movements by the age of 3 years [3]. Because of increased cost of 3-stage operations [4], [5], especially in developing countries, and well-known problems with
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2021, Journal of Pediatric SurgeryCitation Excerpt :The value of colostomy is generally well appreciated in boys with rectourethral fistula (both diagnostic and therapeutic) [3]. Contrarily, in females with rectoperineal/vestibular fistula, the role of protective colostomy has been questioned as several reports have shown the feasibility of primary repair with comparable results [5,11,19–24]. Creating and closing a colostomy are 2 major operations representing a high price that should have a clear indication (advantage) in the management of rectoperineal/vestibular fistula [5].
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