Title

30-day postoperative outcomes of neonatal versus delayed anoplasty for perineal and vestibular fistulas.

Document Type

Article

Publication Date

8-2021

Identifier

DOI: 10.1016/j.jpedsurg.2021.04.023

Abstract

PURPOSE: The purpose of this study was to compare the postoperative outcomes of neonatal versus delayed repair of rectoperineal and rectovestibular fistulae using a multi-center pediatric colorectal specific database. We hypothesized that the incidence of 30-day postoperative complications is not significantly different between these two surgical treatment strategies.

METHODS: We performed a retrospective, observational study of the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) database. We included any patient from the database that underwent primary surgical repair of a rectoperineal or rectovestibular fistula. Neonatal repair was defined as occurring within 14 days of birth, and delayed repair as occurring after that period. The primary outcome was the occurrence of postoperative complications within 30 days.

RESULTS: 164 patients were included in the study (123 rectoperineal, 41 rectovestibular); the majority (81%) were repaired in a delayed fashion. Patients that underwent delayed repair had lower birth weights and were more likely to be female than those that underwent neonatal repair. Wound breakdown/dehiscence was the most common complication in both groups (Delayed 5.3% v. Neonatal, 6.5%). We found no significant difference in the incidence of any postoperative complication between groups (Delayed 6.0 v. Neonatal 6.5%, p = 1.0).

CONCLUSION: We concluded there was no significant difference in the incidence of 30-day postoperative complications for neonatal versus delayed repair of rectoperineal and rectovestibular fistulae, suggesting that both strategies are safe and may have excellent short-term outcomes in appropriately selected patients.

Journal Title

Journal of pediatric surgery

Volume

56

Issue

8

First Page

1454

Last Page

1458

MeSH Keywords

Anal Canal; Child; Digestive System Surgical Procedures; Female; Humans; Infant; Infant, Newborn; Male; Perineum; Postoperative Complications; Rectal Fistula; Retrospective Studies

Keywords

ARMs; Anoplasty; Anorectal malformations; Rectoperineal fistula; Rectovestibular fistula

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