Pediatric surgery international · 2026
Should pull through be offered to patients with cloacal exstrophy?
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Vincent Sage A, Merritt Annie, Evans Lauren L, De la Torre Luis, Alaniz Veronica I, Peña Alberto, Harris Kelly T, Bischoff Andrea
Аннотация
PURPOSE: Worldwide, pull through is uncommon in patients with cloacal exstrophy due to heterogeneous outcomes, however it is frequently performed at our center. We characterized this population and their longitudinal outcomes.
METHODS: A review of a prospectively maintained database (1981-present) of patients with cloacal exstrophy was conducted, noting demographics, associated anomalies, surgical history, and outcomes at most recent follow up.
RESULTS: There were 91 patients with cloacal exstrophy (67 classic, 24 covered). Pull through, offered based on trial of bowel management through the stoma, was performed in 58 patients (63.7%) at median age 2.46 years (IQR 1.44, 5.08). The most frequent reasons to not undergo pull through were failed stoma bowel management (39.4%) and patient/family preference (33.3%). Outcomes, assessed at median 4.84 years post pull through, were reported in 40/58 patients, among which 36 were clean for stool or continent and 4 patients underwent reversal.
CONCLUSION: With preservation of colon and incorporation into the gastrointestinal tract at initial operation, followed by successful bowel management through the stoma, a pull through was performed in 63.7% of patients. Candidacy for pull through should be assessed, ideally prior to, or concurrent with, bladder reconstruction.
METHODS: A review of a prospectively maintained database (1981-present) of patients with cloacal exstrophy was conducted, noting demographics, associated anomalies, surgical history, and outcomes at most recent follow up.
RESULTS: There were 91 patients with cloacal exstrophy (67 classic, 24 covered). Pull through, offered based on trial of bowel management through the stoma, was performed in 58 patients (63.7%) at median age 2.46 years (IQR 1.44, 5.08). The most frequent reasons to not undergo pull through were failed stoma bowel management (39.4%) and patient/family preference (33.3%). Outcomes, assessed at median 4.84 years post pull through, were reported in 40/58 patients, among which 36 were clean for stool or continent and 4 patients underwent reversal.
CONCLUSION: With preservation of colon and incorporation into the gastrointestinal tract at initial operation, followed by successful bowel management through the stoma, a pull through was performed in 63.7% of patients. Candidacy for pull through should be assessed, ideally prior to, or concurrent with, bladder reconstruction.