Sen Li* and Jun Wang
Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, ChinaFulltext PDF
Background: The perineal fistula with high dilated colon is a rare anomalous in the spectrum of
anorectal malformations. The aim of this study is to explore the diagnosis and treatment of this
Special type of Perineal Fistula (SPF), and to avoid the severe consequence due to misdiagnosis.
Methods: From March 2012 to January 2019, 7 patients who suffered from perineal fistula with high
dilated colon were retrospectively reviewed. Three were operated on primarily by our department,
and 4 cases were re-operated after a perineal anoplasty repair performed elsewhere. Four were
operated by Laparoscopic Anorectoplasty (LARP), and 3 cases were repaired by Posterior Sagittal
Anorectoplasty (PSARP). The follow-up outcomes were compared with 71 cases of Normal Perineal
Fistula (NPF) in the same period.
Results: Seven cases have been followed up for 0.5 years to 4 years (M=2.57 ± 1.26) after definitive
surgery. Their Bowel Function Score (BFS) was lower than normal perineal fistula (SPF=12, rang:
5 to 18; NPF=18.5, rang: 18 to 20). Four cases underwent anorectomanometry. The incidence of
Rectoanal Inhibitory Reflex (RAIR) was lower in the special type group. (p=0.14). Three cases of
barium enema angiography: 2 cases of colorectal dilatation and thickening changes, 1 case showed
no obvious abnormalities.
Conclusion: Anorectal perineal fistula should be examined by distal colostogram at pre-operation.
Select appropriate surgical approach is essential for children’s defecation function, and blind surgery
can seriously affect long-term defecation function.
Anorectal malformation; Perineal fistula; Distal colostogram; Laparoscopic anorectoplasty; Posterior sagittal anorectoplasty
Li S, Wang J. Perineal Fistula with High Dilated Colon: One of a Special Type of Anorectal Malformations. World J Surg Surgical Res. 2020; 3: 1254..