Anal transposition without colostomy: functional results and complications
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Published on: July 12, 2018
1Department of Pediatric Surgery, Social Security Council Ankara Children's Hospital, Ankara, Turkey.
Insights
Fistula transposition without colostomy is an effective surgical treatment for female infants with rectovestibular fistula (RVF), yielding excellent functional bowel results and minimal complications. This method is preferred for RVF repair when the rectovaginal septum allows for dissection.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Anorectal Malformations
Background:
- Rectovestibular fistula (RVF) is the most common anorectal anomaly in female infants.
- Current surgical techniques include cutback, fistula transposition (with or without colostomy), and posterior anorectoplasty with colostomy.
Purpose of the Study:
- To retrospectively evaluate the functional outcomes and complications of fistula transposition without colostomy in treating RVF.
- To determine the efficacy of this surgical approach for RVF repair.
Main Methods:
- Retrospective evaluation of 47 female infants with RVF who underwent fistula transposition without colostomy.
- Surgical intervention was preferred when the rectovaginal septum width exceeded 2 mm for optimal dissection.
Main Results:
- All patients achieved voluntary bowel movements.
- 60% had normal bowel habits, and 96% had good functional results.
- No serious complications like infection, dehiscence, or fistula recurrence were observed.
Conclusions:
- Fistula transposition without colostomy is a safe and effective surgical treatment for RVF.
- This technique offers favorable functional outcomes and avoids significant surgical complications, making it a preferred method for RVF repair.
Abstract:
Rectovestibular fistula (RVF) is the most common form of anorectal anomaly in female infants. In the surgical repair of these malformations, most pediatric surgeons use cutback, fistula transposition with or without colostomy, and lately, posterior anorectoplasty with colostomy. This is a retrospective evaluation of the functional results and complications in 47 patients who underwent fistula transposition without colostomy for the treatment of a RVF. We prefer to perform the operation when the rectovaginal septum is amenable to dissection (width >2 mm). All patients had voluntary bowel movements; 28 (60%) had completely normal bowel habits, 45 (96%) good and only 2 (4%) fair. We did not encounter serious surgical complications such as infection dehiscence, and fistula recurrence. We thus prefer anal transposition without colostomy to other modes of surgical therapy for RVF.
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