Вибір тактики хірургічного лікування природжених аноректальних вад розвитку з ректовестибулярною норицею в дівчаток

Abstract

Anorectal malformations in girls include a wide range of abnormalities, from the non-perforated anal membrane to the cloaca. The most common is rectovestibular fistula. Purpose - to improve the results of surgical treatment of congenital anorectal malformations with rectovestibular fistula in girls using a differentiated approach to the choice of treatment tactics. Materials and methods. A comprehensive examination of children was performed. Associated congenital malformations diagnosed with this type of anorectal anomaly have been diagnosed. According to the literature, a comparative analysis of different methods of treatment of this pathology was conducted, using primary anterior sagittal and posterior sagittal anorectoplasty, as well as two-stage or three-stage correction. The analysis of own results of three-stage surgical treatment at 35 girls with a rectovestibular fistula was carried out. The first stage was the formation of a colostomy. The second stage was differentiated, using anterior sagittal or posterior sagittal anorectoplasty. Results. The third was the closure of the colostomy. In patients who underwent anterior sagittal anorectoplasty, the results were good in 6 (60%) and in 4 (40%) - satisfactory, and in posterior sagittal anorectoplasty - in 14 (60.9%) good, and in 9 (39.1%) - satisfactory. There were no unsatisfactory results. Conclusions. With adequate colostomy, the results of anterior sagittal and posterior sagittal anorectoplasty in the postoperative period are not significant. The choice of tactics for the treatment of rectovestibular fistula in children should be determined by the surgeon, based on the general condition of the child, the presence of associated pathology and perfection of mastery of the method of correction. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.