Anterior perineal fistulectomy in repairing H-type rectovestibular fistula with a normal anus in female children

Abstract

The purpose of this study was to review a 7-year operative experience of anterior perineal fistulectomy in repairing H-type rectovestibular fistula with a normal anus in female children. From January 2007 to December 2013, 105 female children with H-type rectovestibular fistula and a normal anus underwent anterior perineal fistulectomy in the Department of General Surgery, Beijing Children’s Hospital, Capital Medical University. Clinical data were retrospectively analyzed. Patients’ age ranged from 6months to 13years 10months, with an average age 5years 2months. The clinical feature of this disease was a definite history of vestibular infection at about 30days after birth and leakage of gas or loose stool through vestibular fistular orifice after the infection was controlled. All patients had a normal anus. Follow-up through telephone or outpatient visits from 6months to 7years (median, 5.2years), showed that all the patients were continent and had regular bowel movements. Among the 105 patients, 97 (92.4%) gained primary healing with a satisfactory appearance; 8 (7.6%) patients relapsed, among which 5 healed after hip bathing treatment within 3weeks, 2 required another anterior perineal fistulectomy 7months later and were cured, and the last one had another anterior perineal fistulectomy 1year 10months later but relapsed again, which healed after hip bathing treatment within 3weeks after the second surgery. Anterior perineal fistulectomy is a simple, safe and reliable surgical method to treat H-type rectovestibular fistula with a normal anus.