Postoperative complications after reconstructive surgery for cloacal malformations: a systematic review
H P Versteegh1, J R Sutcliffe, C E J Sloots
1Department of Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, PO Box 2060, 3000 CB, Rotterdam, The Netherlands, h.versteegh@erasmusmc.nl.
Techniques in Coloproctology
|February 23, 2015
Summary
Postoperative complications after cloacal repair occur in 30% of patients. The posterior sagittal anorecto-vagino-urethroplasty (PSARVUP) and total urogenital mobilization (TUM) techniques showed similar complication rates, highlighting the need for standardized reporting.
Area of Science:
- Pediatric Surgery
- Congenital Malformations
- Surgical Outcomes
Background:
- Cloacal malformations are complex congenital anomalies requiring surgical correction.
- Current surgical approaches include posterior sagittal anorecto-vagino-urethroplasty (PSARVUP) and total urogenital mobilization (TUM).
Purpose of the Study:
- To systematically review and analyze the frequency and types of postoperative complications following cloacal repair.
- To compare complication rates between PSARVUP and TUM surgical techniques.
Main Methods:
- A systematic literature search was performed adhering to PRISMA guidelines.
- Eight eligible studies were qualitatively analyzed using the Rangel score.
- A meta-analysis was conducted on the pooled data from the included studies.
Main Results:
- Overall postoperative complication rates in the literature ranged from 0% to 57%.
- Meta-analysis revealed a 30% complication rate (99 out of 327 patients).
- The most frequent complications were recurrent/persistent fistula (10%) and rectal prolapse (10%).
- Complication rates were 40% for PSARVUP and 30% for TUM, with no significant difference (p=0.205).
Conclusions:
- Postoperative complications are observed in approximately 30% of patients undergoing cloacal repair.
- There is no statistically significant difference in complication rates between PSARVUP and TUM.
- Standardized reporting of surgical complications is crucial for advancing surgical techniques in treating cloacal malformations.
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