Journal of pediatric surgery · 2009
Division of the fistula in laparoscopic-assisted repair of anorectal malformations-are clips or ties necessary?
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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.
Rollins Michael D, Downey Earl C, Meyers Rebecka L, Scaife Eric R
Аннотация
BACKGROUND: Laparoscopic-assisted anorectoplasty (LAARP) was introduced in 2000 by Georgeson (J Pediatr Surg. 2000;35:927-930) and has gained interest because of improved visualization of the rectal fistula and the ability to place the pull-through segment within the levator muscle complex with minimal dissection. Currently, there is no consensus on how the fistula should be managed during LAARP. We postulated that the fistula could be managed with simple division and temporary diversion of urine through a Foley catheter without surgical ligation of the fistula similar to the management of a traumatic urethral injury.
METHODS: A retrospective chart review was performed of patients with imperforate anus who underwent LAARP between January 2005 and September 2007.
RESULTS: Eight patients were managed with a LAARP. Five male patients had the fistula simply divided. In these 5 patients, the location of the fistula was rectoprostatic (2) and rectobulbar (3). The Foley catheter was left in position until a retrograde urethrogram demonstrated no evidence of a leak (range, 6-40 days). There were no postoperative urethral strictures and one diverticulum. Follow-up has ranged from 10 to 19 months.
CONCLUSION: Male patients with a rectourethral fistula at or just below the prostate can be safely and successfully managed with simple division of the fistula.
METHODS: A retrospective chart review was performed of patients with imperforate anus who underwent LAARP between January 2005 and September 2007.
RESULTS: Eight patients were managed with a LAARP. Five male patients had the fistula simply divided. In these 5 patients, the location of the fistula was rectoprostatic (2) and rectobulbar (3). The Foley catheter was left in position until a retrograde urethrogram demonstrated no evidence of a leak (range, 6-40 days). There were no postoperative urethral strictures and one diverticulum. Follow-up has ranged from 10 to 19 months.
CONCLUSION: Male patients with a rectourethral fistula at or just below the prostate can be safely and successfully managed with simple division of the fistula.