کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4154663 1411249 2016 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Anorectal malformation with rectobladder neck fistula: A distinct and challenging malformation
ترجمه فارسی عنوان
ناهنجاری انحصاری با فیستول گردن رکتوبلدرز: ناهنجاری متمایز و چالش انگیز
کلمات کلیدی
ASD، نقص دیواره دهلیزی؛ CIC، کاتتریزاسیون متناوب تمیز؛ PSARP، anorectoplasty خلفی ساژیتال؛ SR، نسبت ساكرال؛ VBM، حرکات داوطلبانه روده؛ VM، verumontanum؛ VUR، ریفلاکس vesicoureteral malformation انورکتال؛ فیستول گردن رکتومردر
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پریناتولوژی (پزشکی مادر و جنین)، طب اطفال و بهداشت کودک
چکیده انگلیسی

BackgroundRectobladder neck fistula is the highest and most complex anorectal malformation in boys and the only one that requires an abdominal approach, open or laparoscopic, for repair. The aim of this study was to describe the unique characteristics of rectobladder neck fistulas that warrant special attention and to describe the associated anatomic variants in the genitourinary tract.MethodsThe database of a tertiary medical center was retrospectively reviewed for all patients treated for rectobladder neck fistula, by our team in 1980–2011. Data on surgical history, associated and functional defects, treatment and outcome were collected by chart review.ResultsThe study group included 111 patients. The most common anatomic urologic defect was a single kidney in 37 patients (33.3%) and the most common functional urologic defect was vesicoureteral reflux in 40 patients (36%), including 11/37 patients with a single kidney (29.7%). Of the 40 patients who underwent cystoscopy, 16 (40%) had a higher than normal location of the verumontanum. Follow-up ranged from 2 to 290 months (median 59). Urinary continence was achieved in 40 of the 61 patients (65.5%) for whom data were available, and fecal continence was achieved in 9 of the 69 patients (13%) for whom data were available. A sacral ratio of 0.4 or less was associated with lower rates of urinary control (23%) and fecal control (0%), relative to higher ratios. Twenty stomas (18%) were found to be located too distally, limiting the availability of the bowel for a pull through.ConclusionsRectobladder neck fistula carries a poor prognosis for bowel control and is associated with a high rate of urinary malformations that require long-term care. Pediatric surgeons need to be aware of these complications in order to provide proper treatment and parental counseling. Intra-vesical verumontanum is found in a surprisingly high percentage of patients. The combination of a single kidney with vesicoureteral reflux is common and should be closely followed to avoid renal deterioration. Special attention should be given to colostomy construction to avoid complications and unnecessary procedures. A sacral ratio of 0.4 or less is an indicator of poor fecal and urinary control.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Pediatric Surgery - Volume 51, Issue 10, October 2016, Pages 1592–1596
نویسندگان
, , , , ,