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Evaluation and management of rectovaginal fistula in anorectal malformation: an observational study

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Abstract

Purpose

The rectovaginal fistula (RVF) is a type of female ARM in which the rectum terminates in the vagina. Due to its rarity, there are limited reports on its presentation, management, and follow-up. This paper deals with the clinical presentation, management, and outcome of RVF.

Methods

It was a retrospective cohort study of 10 years. The patients were evaluated for age, clinical presentation, associated anomalies, any prior surgical interventions performed elsewhere, and complications. After workup, the patients underwent three stages of surgery.

Results

Fifty-six patients of RVF were managed. The median age was 13.48 months. The associated anomalies were present in 37 (66%) patients. Posterosagittal and anterosagittal anorectoplasty (PSARP and ASARP) were performed in 29 and 6 patients, respectively. Abdominoperineal pull-through (APPT) was performed in 16 patients of congenital pouch colon. The complications of the first stage included stomal stenosis (4) and stomal prolapse (3). Constipation was present in 39 patients 2 years after the third surgery.

Conclusions

RVF is a distinct entity, which needs careful clinical examination. With proper planning for diagnosis and treatment, it can be managed at specialized centers. Care may be needed for the associated anomalies. The follow-up is an integral part of its management.

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Funding

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Authors and Affiliations

  1. Department of Pediatric Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, 226003, India

    Survesh Kumar Gupta, Anand Pandey, Piyush Kumar, Saurabh Srivastava, Sudhir Singh & Jiledar Rawat

Authors
  1. Survesh Kumar Gupta
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  2. Anand Pandey
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  3. Piyush Kumar
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  4. Saurabh Srivastava
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  5. Sudhir Singh
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  6. Jiledar Rawat
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Contributions

SKG and AP conceptualized the idea. PK, SS, SS, and AP performed the literature review and collected the data. AP, SKG, and PK wrote the first draft of the manuscript. JR reviewed the manuscript. AP and JR prepared the final draft. The final version was read and approved by all authors.

Corresponding author

Correspondence to Anand Pandey.

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Conflict of interest

None declared for any author.

Ethical approval

The data of the present study were collected in the course of common clinical practice, and accordingly, the signed informed consent was obtained from each patient for any surgical and clinical procedure. The study protocol was in accordance with the ethical standards of the institutional research committee and the 1964 Helsinki Declaration and its later amendments. Because it was a retrospective study, formal consent for this study was not required, and no approval of the institutional research committee was needed.

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Gupta, S.K., Pandey, A., Kumar, P. et al. Evaluation and management of rectovaginal fistula in anorectal malformation: an observational study. Pediatr Surg Int 37, 1601–1606 (2021). https://doi.org/10.1007/s00383-021-04970-7

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  • DOI: https://doi.org/10.1007/s00383-021-04970-7

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