LONG – TERM OUTCOMES OF TREATMENT RECTOURETHRAL FISTULA BY COMBINED LAPAROSCOPIC AND MODIFIED POSTERIOR SAGITTAL APPROACH SAVING THE EXTERNAL SPHINCTER
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Abstract
Objectives: The aim of this study was to evaluate long - term results of rectourethral fistula treatment by combined laparoscopic and modified posterior sagittal approach saving the external sphincter. Patients and methods: All patients with rectourethral fistula treated by the same mentioned technique between April 2017 and April 2020 were retrospectively studied. Results: Laparoscopic and modified posterior sagittal approach saving the external sphincter was completed on 52 patients with rectourethral fistula, including 25 patients with rectoprostate fistulas and 27 patients with rectobulbar fistulas. Mean operative time was 57.8 ± 5.7 minutes (48 to 80 minutes). There were no intraoperative complications and no perioperative mortalities. The mean hospital stay was 5.1 ± 0.9 days. As for the long-term results, constipation rate was 13.3%, Soiling rate was 46,7%, totally continent rate was 82.3%. Conclusion: Combined laparoscopic and modified posterior sagittal approach saving the external sphincter is feasible and safe for rectourethral fistula. Long-term follow-up shows a high rate of totally continent defecation.
Article Details
Keywords
Rectourethral fistula, Combined laparoscopic and modified posterior sagittal approach, external sphincter.
References
2. Peña A, Levitt M A. Anorectal Malfomation. chapter 101, in Pediatric Surgery, sixth edition, Jay L Grosfeld, 2006, 1566- 1589.
3. Long L, Ren X, Ming A, et al. Laparoscopic surgical technique to enhance the management of anorectal malformations: 330 cases' experience in a single center. Pediatr Surg Int. Mar 2020;36(3):279-287.
4. Xiao H, Chen L, Ren XH, et al. One-Stage Laparoscopic-Assisted Anorectoplasty for Neonates with Anorectal Malformation and Recto-Prostatic or Recto-Bulbar Fistula According to the Krickenbeck Classification. J Laparoendosc Adv Surg Tech A. Aug 2018;28(8):1029-1034.
5. Divarci E, Ergun O. General complications after surgery for anorectal malformations. Pediatr Surg Int. Apr 2020;36(4):431-445.
6. Yazaki Y, Koga H, Ochi T, et al. Surgical management of recto-prostatic and recto-bulbar anorectal malformations. Pediatr Surg Int. Oct 2016;32(10):939-44.
7. Ming A X, Li L, Diao M, et al. Long term outcomes of laparoscopic-assisted anorectoplasty: a comparison study with posterior sagittal anorectoplasty. J Pediatr Surg. Apr 2014;49(4):560-3.
8. Ren X, Xu H, Jiang Q, et al. Single-incision laparoscopic-assisted anorectoplasty for treating children with intermediate-type anorectal malformations and rectobulbar fistula: a comparative study. Pediatr Surg Int. Nov 2019; 35(11):1255-1263.