Clinical Features and Therapeutic Strategies for Recto-Vulval Fistula With Normal Anus

Mukai Motoi, Matsufuji Hiroshi, Kaji Tatsuru, Kawano Takafumi, Matsukubo Makoto, Migita Misato, Takamatsu Hideo

doi:10.11164/jjsps.47.1_31

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正常肛門を有する女児直腸陰部瘻の検討
正常肛門を有する女児直腸陰部瘻の検針
セイジョウコウモンオユウスルジョジチョクチョウインブロウノケンシン

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Purpose: We discuss the etiology, therapeutic strategy, and surgical procedure of recto-vulval fistula with normal anus. Methods: We retrospectively reviewed the clinical features, treatment, and postoperative course of eight patients at our institution. Clinical data were acquired from the medical records. Onset of disease was between 3 weeks and 3 months of age. Vulval orifices lay at the vestibular fossa in 5 cases, at the vaginal lip in two cases and at the vagina in one case. Results: Vaginal lip fistulas in two patients healed spontaneously. The remaining 6 patients underwent surgery. The operative procedures were transperineal removal of the fistula in 4 patients, vestibulo-anal pull through in one patient, and pull through of the anterior wall of the rectum in one patient. Three of them had a preliminary colostomy. Two patients undergoing transperineal fistulectomy and preliminary colostomy suffered a recurrence. Conclusion: Recto-vulval fistula with normal anus has a varied etiology and pathophysiology. Our results indicated that the pull through of the anterior wall of the rectum should be preferable, as shown in previously published studies.

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Journal of the Japanese Society of Pediatric Surgeons

Journal of the Japanese Society of Pediatric Surgeons 47 (1), 31-34, 2011

The Japanese Society of Pediatric Surgeons

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