Treatment of pediatric H-type rectovestibular fistula with tension-free repair of rectal seromuscular layer
Objective: This study aimed to assess the outcomes of a 7-year experience with tension-free repair of the rectal seromuscular layer for H-type rectovestibular fistula in female children with a normal anus. Methods: Between May 2016 and January 2023, 86 patients with H-type rectovestibular fistula un...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Journal of Pediatric Surgery Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949711623000990 |
| _version_ | 1797347021812662272 |
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| author | Mao Ye Zhen Chen Jun Zhang Cuizhu Feng Xu Li |
| author_facet | Mao Ye Zhen Chen Jun Zhang Cuizhu Feng Xu Li |
| author_sort | Mao Ye |
| collection | DOAJ |
| description | Objective: This study aimed to assess the outcomes of a 7-year experience with tension-free repair of the rectal seromuscular layer for H-type rectovestibular fistula in female children with a normal anus. Methods: Between May 2016 and January 2023, 86 patients with H-type rectovestibular fistula underwent a standardized surgical procedure conducted by the same surgical team. The procedure involved: (1) Identifying and locating the vestibular orifice. (2) Dissecting the fistula. (3) Dissecting the anterior rectal wall. (4) Repairing the fistula. (5) Closing the internal opening of the fistula. During the dissection of the rectovaginal septum, care was taken to avoid any harm to the posterior wall of the vagina while exposing the anterior rectal wall by 10–25 mm. Results: Follow-up, conducted via telephone or outpatient visits, ranged from 3 months to 6 years and 11 months (median, 3.5 years). In 82 cases (95.35% of 86), primary healing was achieved, resulting in satisfactory perineal appearance, smooth stool passage, and regular defecation. In 4 cases (4.65% of 86), fistula recurrence occurred within 5 to 10 days post-surgery. One case healed within 3 weeks with 3% boric acid sitz baths. The other 2 cases underwent debridement 7 days after the initial operation, leading to successful recovery. The final case experienced a recurrence 1 year after surgery following resection and repair of the perineal fistula, and no further surgical intervention was pursued. Conclusion: Tension-free repair of the rectal seromuscular layer represents a straightforward, safe, and effective surgical approach for managing H-type rectovestibular fistula with a normal anus in female children. |
| first_indexed | 2024-03-08T11:41:33Z |
| format | Article |
| id | doaj.art-8ec8bbafb8a442c984b9ee5fcaa6fad7 |
| institution | Directory Open Access Journal |
| issn | 2949-7116 |
| language | English |
| last_indexed | 2024-03-08T11:41:33Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Open |
| spelling | doaj.art-8ec8bbafb8a442c984b9ee5fcaa6fad72024-01-25T05:24:57ZengElsevierJournal of Pediatric Surgery Open2949-71162024-01-015100102Treatment of pediatric H-type rectovestibular fistula with tension-free repair of rectal seromuscular layerMao Ye0Zhen Chen1Jun Zhang2Cuizhu Feng3Xu Li4Department of Surgery, Capital Institute of Pediatrics affiliated Children Hospital, No.2, Yabao Rd, Chaoyang district, Beijing 100020 ChinaDepartment of Surgery, Capital Institute of Pediatrics affiliated Children Hospital, No.2, Yabao Rd, Chaoyang district, Beijing 100020 ChinaDepartment of Surgery, Capital Institute of Pediatrics affiliated Children Hospital, No.2, Yabao Rd, Chaoyang district, Beijing 100020 ChinaDepartment of Surgery, Capital Institute of Pediatrics affiliated Children Hospital, No.2, Yabao Rd, Chaoyang district, Beijing 100020 ChinaDepartment of Surgery, Capital Institute of Pediatrics affiliated Children Hospital, No.2, Yabao Rd, Chaoyang district, Beijing 100020 China; Research Unit of Minimally Invasive Pediatric Surgery on Diagnosis and Treatment, Chinese Academy of Medical Sciences 2021RU015, Beijing 100730 China; Corresponding author.Objective: This study aimed to assess the outcomes of a 7-year experience with tension-free repair of the rectal seromuscular layer for H-type rectovestibular fistula in female children with a normal anus. Methods: Between May 2016 and January 2023, 86 patients with H-type rectovestibular fistula underwent a standardized surgical procedure conducted by the same surgical team. The procedure involved: (1) Identifying and locating the vestibular orifice. (2) Dissecting the fistula. (3) Dissecting the anterior rectal wall. (4) Repairing the fistula. (5) Closing the internal opening of the fistula. During the dissection of the rectovaginal septum, care was taken to avoid any harm to the posterior wall of the vagina while exposing the anterior rectal wall by 10–25 mm. Results: Follow-up, conducted via telephone or outpatient visits, ranged from 3 months to 6 years and 11 months (median, 3.5 years). In 82 cases (95.35% of 86), primary healing was achieved, resulting in satisfactory perineal appearance, smooth stool passage, and regular defecation. In 4 cases (4.65% of 86), fistula recurrence occurred within 5 to 10 days post-surgery. One case healed within 3 weeks with 3% boric acid sitz baths. The other 2 cases underwent debridement 7 days after the initial operation, leading to successful recovery. The final case experienced a recurrence 1 year after surgery following resection and repair of the perineal fistula, and no further surgical intervention was pursued. Conclusion: Tension-free repair of the rectal seromuscular layer represents a straightforward, safe, and effective surgical approach for managing H-type rectovestibular fistula with a normal anus in female children.http://www.sciencedirect.com/science/article/pii/S2949711623000990Rectovestibular fistulaH-typeAcquiredNormal anusAnorectal malformation |
| spellingShingle | Mao Ye Zhen Chen Jun Zhang Cuizhu Feng Xu Li Treatment of pediatric H-type rectovestibular fistula with tension-free repair of rectal seromuscular layer Journal of Pediatric Surgery Open Rectovestibular fistula H-type Acquired Normal anus Anorectal malformation |
| title | Treatment of pediatric H-type rectovestibular fistula with tension-free repair of rectal seromuscular layer |
| title_full | Treatment of pediatric H-type rectovestibular fistula with tension-free repair of rectal seromuscular layer |
| title_fullStr | Treatment of pediatric H-type rectovestibular fistula with tension-free repair of rectal seromuscular layer |
| title_full_unstemmed | Treatment of pediatric H-type rectovestibular fistula with tension-free repair of rectal seromuscular layer |
| title_short | Treatment of pediatric H-type rectovestibular fistula with tension-free repair of rectal seromuscular layer |
| title_sort | treatment of pediatric h type rectovestibular fistula with tension free repair of rectal seromuscular layer |
| topic | Rectovestibular fistula H-type Acquired Normal anus Anorectal malformation |
| url | http://www.sciencedirect.com/science/article/pii/S2949711623000990 |
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