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Pediatric Surgery International

, Volume 35, Issue 1, pp 77–85 | Cite as

One-stage repair of anorectal malformations in females with vestibular fistula: a systematic review and meta-analysis

  • Giuseppe LauritiEmail author
  • Dacia Di Renzo
  • Pierluigi Lelli Chiesa
  • Augusto Zani
  • Agostino Pierro
Original Article
  • 232 Downloads

Abstract

Purpose

Females with recto-vestibular fistula (RVF) can be managed either by one-stage sagittal anorectoplasty (SARP) or by conventional multi-stage approach with colostomy followed by SARP. Our aim was to define which approach, one-stage or multi-stage, is safer and more beneficial.

Methods

Using a defined search strategy, two investigators identified all comparative studies on the mentioned procedures. The study was conducted under PRISMA guidelines. The meta-analysis was performed using RevMan 5.3. Data are mean ± SD.

Results

Of 649 titles/abstracts screened, 13 full-text articles were analyzed. Three studies were included (156 females). One-stage SARP was associated with increased risk of wound infection (24.3 ± 8.7%) compared to multi-stage approach (10.9 ± 2.5%; p < 0.01) and increased risk of wound dehiscence (16.2 ± 4.8% vs. 2.4 ± 1.1%, respectively; p < 0.01). The incidence of anorectal stenosis was higher following one-stage repair (33.3%) vs. multi-stage approach (10.7%; p < 0.05). No differences were found with regards to redo SARP in both groups (12.9 ± 7.3% vs. 4.8 ± 0.8%; p = ns). At follow-up, the prevalence of soiling and constipation were similar after one-stage (19.7 ± 10.3% and 29.5 ± 5.4%) and multi-stage repair (13.7 ± 8.9% and 28.7 ± 4.4%; p = ns).

Conclusions

In females with RVF, the SARP performed without protective colostomy increases the risk of postoperative complications. However, this one-stage approach seems not to be associated with reduced fecal continence.

Keywords

Anorectal malformations Recto-vestibular fistula One-stage sagittal anorectoplasty Systematic review Meta-analysis 

Notes

Funding

This study was not funded by any grant.

Compliance with ethical standards

Conflict of interest

Authors have no potential conflicts of interest for this study.

Ethical approval

Not applicable, since the study was a systematic review and meta-analysis.

Informed consent

Not applicable, since the study was a systematic review and meta-analysis.

Supplementary material

383_2018_4378_MOESM1_ESM.docx (21 kb)
Supplementary material 1 (DOCX 21 KB)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Giuseppe Lauriti
    • 1
    • 2
    • 3
    Email author
  • Dacia Di Renzo
    • 2
    • 3
  • Pierluigi Lelli Chiesa
    • 2
    • 3
  • Augusto Zani
    • 1
  • Agostino Pierro
    • 1
  1. 1.Division of General and Thoracic Surgery, The Hospital for Sick ChildrenUniversity of TorontoTorontoCanada
  2. 2.Department of Pediatric Surgery“Spirito Santo” Hospital of PescaraPescaraItaly
  3. 3.“G. d’Annunzio” University of Chieti-PescaraChietiItaly

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