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One-stage repair of anorectal malformations in females with vestibular fistula: a systematic review and meta-analysis.
Lauriti, Giuseppe; Di Renzo, Dacia; Lelli Chiesa, Pierluigi; Zani, Augusto; Pierro, Agostino.
Afiliação
  • Lauriti G; Division of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada. giuseppe.lauriti@gmail.com.
  • Di Renzo D; Department of Pediatric Surgery, "Spirito Santo" Hospital of Pescara, Pescara, Italy. giuseppe.lauriti@gmail.com.
  • Lelli Chiesa P; "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy. giuseppe.lauriti@gmail.com.
  • Zani A; Department of Pediatric Surgery, "Spirito Santo" Hospital of Pescara, Pescara, Italy.
  • Pierro A; "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.
Pediatr Surg Int ; 35(1): 77-85, 2019 Jan.
Article em En | MEDLINE | ID: mdl-30377757
ABSTRACT

PURPOSE:

Females with recto-vestibular fistula (RVF) can be managed either by one-stage sagittal anorectoplasty (SARP) or by conventional multi-stage approach with colostomy followed by SARP. Our aim was to define which approach, one-stage or multi-stage, is safer and more beneficial.

METHODS:

Using a defined search strategy, two investigators identified all comparative studies on the mentioned procedures. The study was conducted under PRISMA guidelines. The meta-analysis was performed using RevMan 5.3. Data are mean ± SD.

RESULTS:

Of 649 titles/abstracts screened, 13 full-text articles were analyzed. Three studies were included (156 females). One-stage SARP was associated with increased risk of wound infection (24.3 ± 8.7%) compared to multi-stage approach (10.9 ± 2.5%; p < 0.01) and increased risk of wound dehiscence (16.2 ± 4.8% vs. 2.4 ± 1.1%, respectively; p < 0.01). The incidence of anorectal stenosis was higher following one-stage repair (33.3%) vs. multi-stage approach (10.7%; p < 0.05). No differences were found with regards to redo SARP in both groups (12.9 ± 7.3% vs. 4.8 ± 0.8%; p = ns). At follow-up, the prevalence of soiling and constipation were similar after one-stage (19.7 ± 10.3% and 29.5 ± 5.4%) and multi-stage repair (13.7 ± 8.9% and 28.7 ± 4.4%; p = ns).

CONCLUSIONS:

In females with RVF, the SARP performed without protective colostomy increases the risk of postoperative complications. However, this one-stage approach seems not to be associated with reduced fecal continence.
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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Canal Anal / Reto / Procedimentos Cirúrgicos do Sistema Digestório / Fístula Retovaginal / Constipação Intestinal / Procedimentos de Cirurgia Plástica / Malformações Anorretais Tipo de estudo: Risk_factors_studies / Systematic_reviews Limite: Female / Humans Idioma: En Revista: Pediatr Surg Int Assunto da revista: PEDIATRIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Canadá

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Canal Anal / Reto / Procedimentos Cirúrgicos do Sistema Digestório / Fístula Retovaginal / Constipação Intestinal / Procedimentos de Cirurgia Plástica / Malformações Anorretais Tipo de estudo: Risk_factors_studies / Systematic_reviews Limite: Female / Humans Idioma: En Revista: Pediatr Surg Int Assunto da revista: PEDIATRIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Canadá