Recto-vestibular disruption defect resulted from the malpractice in the treatment of the acquired recto-vestibular fistula in infants

doi:10.3748/wjg.v13.i13.1980

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Apr 7, 2007; 13(13): 1980-1982
Published online Apr 7, 2007. doi: 10.3748/wjg.v13.i13.1980

Recto-vestibular disruption defect resulted from the malpractice in the treatment of the acquired recto-vestibular fistula in infants

Ting-Chong Zhang, Wen-Bo Pang, Ya-Jun Chen, Jin-Zhe Zhang

Ting-Chong Zhang, Wen-Bo Pang, Ya-Jun Chen, Jin-Zhe Zhang, Department of Surgery, Beijing Children’s Hospital affiliated to Capital Medical University, Beijing 100045, China

Author contributions: All authors contributed equally to the work.

Correspondence to: Dr. Ya-Jun Chen, MD, Department of Surgery, Beijing Children’s Hospital affiliated to Capital Medical University, Beijing 100045, China. chenyajunmd@yahoo.com.cn

Telephone: +86-10-68028401-2403

Received: January 5, 2007
Revised: February 18, 2007
Accepted: March 14, 2007
Published online: April 7, 2007

Abstract

AIM: To explore the pathogenesis of the rectovestibular disruption (RVD) defect and to recommend a successful repair, and prevention of it.

METHODS: Clinical records of 15 girls, age ranged from 3 to 15 (median, 7.5) years, with acquired rectovestibular fistula (RVF) mistreated before were retrospectively reviewed. All of them presented an abnormal appearance of perineum and were suffering from some degree of fecal incontinence, and those were graded III to IV by Li Zheng’s Score. Repair of anal sphincters and reconstruction of perineum body and skin by anterior perineal rectoanoplasty were performed in all cases.

RESULTS: Operation in all cases was successful. The perineum looked practically normal and fecal continence score rose up to VI by Li Zheng’s Score.

CONCLUSION: The conventional treatment for anal fistula, lay-open or string-treatment, should be considered as malpractice of RVF, and certainly leads to the RVD defect, and the anterior perineal rectoanoplasty could cure it satisfactorily.

Keywords: Rectovestibular fistula, Acquired, Disruption, Children