- 作者：Michael D. Rollins ; Katie Russell ; Kathy Schall ; Sarah Zobell ; Ramon F. Castillo II ; Lesley Eldridge ; Eric R. Scaife ; Douglas C. Barnhart
- 关键词：Anorectal malformations ; Perineal fistula ; Rectoperineal fistula ; Ectopic anus
- 刊名：Journal of Pediatric Surgery
- 出版年：January, 2014
- 年：2014
- 卷：49
- 期：1
- 页码：95-98
- 全文大小：362 K
Purpose
Given that a rectoperineal fistula is developmentally the most mature lesion in the spectrum of anorectal malformations, it is not clear whether it merits a complete VACTERL evaluation. We sought to determine if the same evaluation is required to rule out associated anomalies in newborns with rectoperineal fistula as those with more complex anorectal malformations.Methods
We performed a retrospective review of the pediatric colorectal center database at our tertiary care children鈥檚 hospital from 2000 to 2012. Patients with anorectal malformations were categorized as rectoperineal fistula or 鈥渙ther鈥?using the Krickenbeck classification. Records were reviewed to identify associated anomalies.
Results
308 patients (156 males) were treated at our institution during the time period (rectoperineal fistula = 102). Thirty-five (34%) patients with a perineal fistula had at least one associated anomaly. The most common anomalies were cardiac lesions (29% excluding PFO and PDA), genitourinary (20.6%), and malformations of the spine (15.7%). The overall occurrence of anomalies was lower than the 鈥渙ther鈥?group.
Conclusion
Our review demonstrates that newborns with a rectoperineal fistula frequently have associated anomalies and should undergo an evaluation similar to more complex lesions. These findings illustrate the importance of a structured approach to the evaluation of even the most straightforward lesions.