Early versus late reconstruction of cloacal malformations: The effects on postoperative complications and long-term colorectal outcome

Versteegh, Hendt P.; Sloots, Cornelius E. J.; Jong, Justin R. de; Sleeboom, C.; Rassouli, Roxana; Heurn, L. W. Ernest van; Zee, David C. van der; Wijnen, René; Blaauw, Ivo de

doi:10.1016/j.jpedsurg.2013.10.028

Cited by 11 publications

(7 citation statements)

References 14 publications

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“…However, in the largest study, postoperative complications were only reported in the 220 TUM patients. One study reported that postoperative complications were assessed within a period of 30 days after surgery, but the other studies did not report the time range in which the complications were assessed [ 12 ].…”

Section: Resultsmentioning

confidence: 99%

“…In two studies, both the PSARVUP and the TUM were used for cloacal reconstruction [ 12 , 13 ]. Two studies reported the use of PSARVUP only [ 14 , 15 ], and in two series, only TUM was used [ 16 , 17 ].…”

Section: Resultsmentioning

confidence: 99%

“…The low complication rate does raise the question of whether failure to report a complication can be equated to absence of the complication for any specific study. Wound dehiscence, for example, was only reported in two studies (14–19 %) [ 12 , 15 ]. It seems unlikely that there was no wound dehiscence in any of the other studies.…”

Section: Discussionmentioning

confidence: 99%

“…Since the need for reoperations is likely to influence outcome, these might be of more importance than the occurrence of the complications themselves [ 20 ]. We encountered several other limitations while conducting this review; only one study reported the length of the postoperative period in which complications were assessed [ 12 ], and seven of the eight studies were retrospective. The fact that most studies comprised retrospective reports may have contributed to a possible underreporting of complications.…”

Section: Discussionmentioning

confidence: 99%

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Postoperative complications after reconstructive surgery for cloacal malformations: a systematic review

et al. 2015

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The repair of cloacal malformations is most often performed using a posterior sagittal anorecto-vagino-urethroplasty (PSARVUP) or total urogenital mobilization (TUM) with or without laparotomy. The aim of this study was to systematically review the frequency and type of postoperative complication seen after cloacal repair as reported in the literature. A systematic literature search was conducted according to preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA). Eight records were eligible for this study which were qualitatively analyzed according to the Rangel score. Overall complication rates reported in included studies ranged from 0 to 57 %. After meta-analysis of data, postoperative complications were seen in 99 of 327 patients (30 %). The most common reported complications were recurrent or persistent fistula (n = 29, 10 %) and rectal prolapse (n = 27, 10 %). In the PSARVUP group, the complication rate was 40 % and in the TUM group 30 % (p = 0.205). This systematic review shows that postoperative complications after cloacal repair are seen in 30 % of the patients. The complication rates after PSARVUP and TUM were not significantly different. Standardization in reporting of surgical complications would inform further development of surgical approaches. Other techniques aiming to lower postoperative complication rates may also deserve consideration.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Postoperative complications after reconstructive surgery for cloacal malformations: a systematic review

et al. 2015

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“…Тем не менее данное утверждение вряд ли можно считать достоверным, поскольку во всех описанных случаях проводилось раздельное низведение кишки и урогенитального комплекса [7,8,11]. Следует отметить, что в большинстве исследований не выявлено статистического различия между возникновением ранних послеоперационных осложнений в зависимости от длины общего канала [3,5,10,11]. Описание ранних осложнений не нашло отражения во всех исследованиях.…”

Section: Discussionunclassified

Results of treatment of fifty children with persistent cloaca in one center

Mokrushina

Геннадьевна²,

Шумихин

et al. 2021

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

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BACKGROUND: The preserved cloaca is a particular type of anorectal anomaly. The combination of urological, genital, and rectal abnormalities makes radical reconstruction difficult. MATERIALS AND METHODS: This study examined operations performed in 50 patients with persistent cloaca treated from 2010 to 2021. Two groups are presented: the first with 35 children and a short canal (3 cm), and the second with 15 children and a long canal (3 cm). We examined the prognosis for bowel control, the type of operation, the need for vaginal reconstruction, complications after surgery, and the days of hospital stay. RESULTS: Anomalies of the Mllerian ducts in the second group (94%) were higher than in the first (36%) (p 0.001). The sacral index and myelodysplasia did not differ in both groups. The sacral index in the first group was 0.62 0.14, and in the second group, it was 0.58 0.14 (p = 0.520). Myelodysplasia in the first group was 33%, and in the second group, it was 38% (p = 0.744). Total urogenital mobilization (51%) was used in the first group, and abdominal reconstruction (54%) was used in the second group. Vaginal reconstruction was required in 28% of patients in the first group and 60% in the second group. Complications were 3.5 times more likely in the first group (60% versus 17% in the second) (p = 0.003). The length of hospital stay in patients in the second group was longer than that of patients in the first group. CONCLUSION: Our study data demonstrate that the reconstruction of a persistent cloaca requires individual planning of the operation, considering the length of the canal and the state of all structures forming the cloaca.

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The accuracy of ultrasound in common channel length measurement compared with intraoperative endoscopy in persistent cloaca patient

Lia,

Kusmayadi,

Bunjamin

2023

Global Pediatrics

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Early versus late reconstruction of cloacal malformations: The effects on postoperative complications and long-term colorectal outcome

Cited by 11 publications

References 14 publications

Postoperative complications after reconstructive surgery for cloacal malformations: a systematic review

Postoperative complications after reconstructive surgery for cloacal malformations: a systematic review

Results of treatment of fifty children with persistent cloaca in one center

The accuracy of ultrasound in common channel length measurement compared with intraoperative endoscopy in persistent cloaca patient

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