Single-stage repair of rectoperineal and rectovestibular fistulae can be safely delayed beyond the neonatal period
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Read the article on jpedsurg.org ↗Article · Mar 2018 · 1 min read
In brief
In brief
Retrospective study of 43 infants demonstrates that single-stage PSARP repair of rectoperineal and rectovestibular fistulae can be safely delayed beyond the neonatal period (median age 166 days). Wound complication rate was 11% with satisfactory healing achieved in all cases through attentive management.
Written by the GCMD Library team from the article.
Purpose
We sought to examine the short-term outcomes following single-stage repair of rectoperineal and rectovestibular fistulae in infants and identify risk factors for wound complication.
Methods
Patients with a rectoperineal or rectovestibular fistula treated with a single-stage repair beyond the neonatal period (>30days of age) at a pediatric colorectal center (2011–2016) were reviewed.
Results
36 patients with a rectoperineal and 7 patients with a rectovestibular fistula were repaired using the Posterior Sagittal Anorectoplasty (PSARP) approach. Median follow-up was 31months. The median age and weight at the time of repair were 166days and 6.5kg. Four patients (11%) suffered a wound complication (3 rectoperineal, 1 rectovestibular). Two required a diverting colostomy to allow wound healing. Two patients suffered skin separation managed with local wound care. All 4 patients experienced satisfactory wound healing without anoplasty stricture. Two different patients developed a stricture of the neo-anus. Age and weight at time of repair, gender, and presence of a genitourinary anomaly were not associated with wound complications.
Conclusion
Delayed single-stage repair of rectoperineal and rectovestibular fistulae can be performed safely in infants beyond the newborn period. With attentive treatment, satisfactory healing can be anticipated if a wound complication is encountered.
Level of Evidence
Retrospective Comparative Study, Level III.