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Pediatric Surgery International
Published in: Pediatric Surgery International 10/2018

01-10-2018 | Original Article

Investigation of the feasibility and safety of single-stage anorectoplasty in neonates with anovestibular fistula

Authors: Chiyoe Shirota, Keisuke Suzuki, Hiroo Uchida, Hiroshi Kawashima, Akinari Hinoki, Takahisa Tainaka, Wataru Sumida, Naruhiko Murase, Kazuo Oshima, Kosuke Chiba, Satoshi Makita, Yujiro Tanaka

Published in: Pediatric Surgery International | Issue 10/2018

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Abstract

Purpose

Anovestibular fistula (AVF) is the most common type of anorectal malformation in females. Delayed anorectoplasty with fistula dilatation is commonly performed during infancy; however, we have been actively performing anorectoplasty in neonates. We report the surgical complications and postoperative defecation function associated with single-stage anorectoplasty performed in neonates.

Methods

Patients who underwent surgery for AVF between 2007 and 2017 at two institutions were retrospectively studied. The operation time, amount of bleeding, time to start oral intake, perioperative complications, and Kelly’s score were compared among patients who underwent surgery as neonates and those who underwent surgery as infants.

Results

Eighteen neonates and 17 infants underwent anterior sagittal anorectoplasty. The median operation time and time to start oral intake were significantly shorter in the neonatal group (72 min; 3 days, respectively) than in the infant group (110 min, p = 0.0002; 5 days, p = 0.0024, respectively). Postoperative wound disruption was significantly more frequent in the infant group. Of the ten patients each in the neonatal and infant groups, there was no significant difference in Kelly’s score at age ≥ 4 years.

Conclusion

Single-stage anorectoplasty in neonates with AVF can be feasibly performed and does not impair postoperative defecation function.

Levels of evidence

III.
Literature
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Metadata
Title
Investigation of the feasibility and safety of single-stage anorectoplasty in neonates with anovestibular fistula
Authors
Chiyoe Shirota
Keisuke Suzuki
Hiroo Uchida
Hiroshi Kawashima
Akinari Hinoki
Takahisa Tainaka
Wataru Sumida
Naruhiko Murase
Kazuo Oshima
Kosuke Chiba
Satoshi Makita
Yujiro Tanaka
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 10/2018
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-018-4324-3

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