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Single stage repair of anovestibular fistula in neonate

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Abstract

Anorectal malformations are one of the most common congenital defects. This study is conducted to evaluate the result of single stage anterior sagittal anorectovaginoplasty (ASARVP) in cases of vestibular anus (AVF) in neonatal age group without thorough gut preparation. All the patients of AVF admitted during 2003–2006 were included in this study. Single stage ASARVP was done in these patients without preparing the bowel in the lithotomy position, the fistula was freed and sufficient length of anorectum was dissected and vagina was separated. Midline incision at the proposed anal site was made, then a plane was dissected between the muscle complex going anteriorly. The mobilized anorectum was pulled to the proposed anal site and proper anoplasty was done. The results were evaluated for duration of surgery, need of bowel preparation, commencement of feed and hospital stay and follow-up (assessment of continence and anal dilatation). A total of 27 patients were included in our study. All patients were less than 1-month-old. Operative time ranges from 50 to 70 min. Bowel preparation was not needed. Per oral feed was started after 48 h in all patients and average duration of hospital stay was 3– 4 days. Postoperative regular anal dilatation was commenced after 1 week of operation. Continence results according to Kelly’s method were good in 70%, fair in 21% and poor 9%. Single-stage anorectovaginoplasty in neonates has a good result in cases of AVF and avoids the need of bowel preparation.

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References

  1. Chatterjee SK (1991) Anorectal malformations. A surgeon’s experience. Oxford University Press, Delhi

    Google Scholar 

  2. Gupta DK, Charles AR, Srinavas M (2002) Pediatric surgery in India—a specialty come of age. Pediatr Surg Int 18:649–652

    PubMed  CAS  Google Scholar 

  3. Santulli TV, Schullinge JN, Liesewette WB, Bill AH Jr (1971) Imperforate anus: a survey from the members of the surgical section of the American Academy of Pediatrics. J Pediatr Surg 6:484–487

    Article  PubMed  CAS  Google Scholar 

  4. Pathak IC, Saifullah S (1969) Congenital anorectal malformations: an experience based on 50 cases. Indian J Pediatr 36:370–379

    PubMed  CAS  Google Scholar 

  5. Bryndorf J, Madsen CM (1960) Ectopic anus in the female. Acta Chir Scand 118:466–478

    PubMed  CAS  Google Scholar 

  6. deVries PA (1984) The surgery for anorectal anomalies. Its evolution with evaluation of procedures. Curr Prob Surg 21(5):1–75

    Article  CAS  Google Scholar 

  7. Stephens FD, Smith ED (1971) Anorectal malformations in Children. Year Book Medical Publishers, Chicago

    Google Scholar 

  8. DeVries PA, Pena A (1982) Posterior sagittal anorectoplasty. J Pediatr Surg 17(5):638–43

    Article  PubMed  CAS  Google Scholar 

  9. Pena A (1985) Surgical treatment of high imperforate anus. World J Surg 9:236–43

    Article  PubMed  CAS  Google Scholar 

  10. Mollard P, Marechal JK, de Beaujeu MJ (1978) Surgical treatment of high imperforate anus with definition of the puborectalis sling by an anterior perineal approach. J Pediatr Surg 13(6):499–5044

    Article  PubMed  CAS  Google Scholar 

  11. Sigalet DL, Laberge JM, Adolph VR, Guttman FM (1996) The anterior sagittal approach for high imperforate anus: a simplification of the Mollard approach. J Pediatr Surg 31(5):625–629

    Article  PubMed  CAS  Google Scholar 

  12. Okada A, Kamata S, Imura K, Fukuzawa M, Kubota A, Yagi M, et al (1992) Anterior sagittal anorectoplasty for rectovestibular and anovestibular fistula. J Pediatr Surg 27(1):85–88

    Article  PubMed  CAS  Google Scholar 

  13. Sigalet DL, Adolph JLVR, Guttman FM (1996) The anterior sagittal approach for high imperforate anus: a simplification of the mollard approach. J Pediatr Surg 31(5):625–629

    Article  PubMed  CAS  Google Scholar 

  14. Aluwihare APR (1990) Primary perineal rectovaginoanoplasty for supralevator imperforate anus in female neonates. J Pediatr Surg 25(20):278–281

    Article  PubMed  CAS  Google Scholar 

  15. Gangopadhyay AN, Gopal SC, Sharma S, Gupta DK, Sharma SP, Mohan TV (2006) Management of anorectal malformations in Varanasi, India: a long-term review of single and three stage procedures. Pediatr Surg Int 22(2):169–72

    Article  PubMed  CAS  Google Scholar 

  16. Gangopadhyay AN, Gopal SC, Sharma S, Gupta DK, Sharma SP, Mohan TV (2005) Single stage management of all pouch colon (anorectal malformation) in newborn. J Pediatr Surg 40:1151–1155

    Article  PubMed  CAS  Google Scholar 

  17. Guochang L, Jiyan Y, Jinmei G, Chunhua W, Tuanguang L (2004) The treatment of high and intermediate anorectal malformations: one stage or three procedures? J Pediatr Surg 39(10):1466–71

    Article  Google Scholar 

  18. Thomas C Moore (1990) Advantages of performing the sagittal anoplasty operation for imperforate anus at birth. J Pediatr Surg 25(2):276–277

    Article  Google Scholar 

  19. Ong NT, Beasly SW (1990) Comparison of clinical methods for the assessment of continence after repair of high anorectal anomalies. Pediatr Surg Int 5:233–237

    Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Surgery IMS, BHU, Varanasi, 221005, UP, India

    Vijay D. Upadhyaya, S. C. Gopal, D. K. Gupta, A. N. Gangopadhyaya, S. P. Sharma & Vijayendra Kumar

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  1. Vijay D. Upadhyaya
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  2. S. C. Gopal
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  3. D. K. Gupta
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  4. A. N. Gangopadhyaya
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  5. S. P. Sharma
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  6. Vijayendra Kumar
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Correspondence to Vijay D. Upadhyaya.

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Upadhyaya, V.D., Gopal, S.C., Gupta, D.K. et al. Single stage repair of anovestibular fistula in neonate. Pediatr Surg Int 23, 737–740 (2007). https://doi.org/10.1007/s00383-007-1965-z

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  • DOI: https://doi.org/10.1007/s00383-007-1965-z

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