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This study was a prospective, randomized, comparative study that included female children with rectovestibular fistulae who were selected from patients with anorectal malformations treated at the pediatric surgical unit, Assiut University Hospital during the period from January 2016 to February 2020. The patients were randomly divided into four groups according to the procedure performed: trans- sphincter anorectoplasty(TSARP), posterior sagittal anorectoplasty, classic anterior sagittal anorectoplasty (ASARP), and modified ASARP.
Background: The management of a vestibular fistula is a challenge for pediatric surgeons. The investigator compared four different operative techniques in terms of postoperative complications, continence, and cosmetic appearance. Patients and methods: This study was a prospective, randomized, comparative study that included female children with rectovestibular fistulae who were selected from patients with anorectal malformations treated at the pediatric surgical unit, Assiut University Hospital during the period from January 2016 to February 2020. The patients were randomly divided into four groups according to the procedure performed: trans- sphincter anorectoplasty(TSARP), posterior sagittal anorectoplasty, classic anterior sagittal anorectoplasty (ASARP), and modified ASARP.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TSARP | Is a surgical procedure |
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| ASARP classic | Surgical procedure |
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| PSARP | Surgical procedure |
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| Modified ASARP | Surgical procedure |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TSARP | Procedure | We make four different surgical operations for female patients with rectovestibular fistula |
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| Measure | Description | Time Frame |
|---|---|---|
| Templeton score | The follow up period is up to one year. scheduled dilatation was followed. Data regarding early (up to 2 weeks) complications, such as wound infection, wound dehiscence, and skin excoriation, and delayed (one months to one year) complications, such as mucosal prolapse, fistula formation, and stenosis, were collected. The anorectal function was measured according to age of continence; younger children who had not attained the age of continence (<3.5 years) had the anocutaneous reflex and anal squeeze on rectal digital examination determined; children older than three and half years had fecal continence rated according to the Templeton score . It designates the operative outcome as "good," "fair," or "poor." The scoring performed prospectively during each follow up visit. | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Anal continence | The assessment period is upto one year. scheduled dilatation was followed. Data regarding early (up to 2 weeks) complications, such as wound infection, wound dehiscence, and skin excoriation, and delayed (one months to one year) complications, such as mucosal prolapse, fistula formation, and stenosis, were collected. The anorectal function was measured according to age of continence; younger children who had not attained the age of continence (<3.5 years) had the anocutaneous reflex and anal squeeze on rectal digital examination determined; children older than three and half years had fecal continence rated according to the Templeton score3 . It designates the operative outcome as "good," "fair," or "poor." The scoring performed prospectively during each follow up visit. |
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Inclusion Criteria:
Exclusion Criteria:
Female children with rectovestibular fistula
This study was a randomized, comparative trial involving female children suffering from vestibular fistula taken from among patients with anorectal malformations treated at the pediatric surgical unit, Assiut University Hospital from January 2016 to February 2020. The patients were randomly separated into four groups according to the procedure performed. The different procedures included were TSARP, PSARP, classic ASARP, and modified ASARP. Randomization did by copies the names of the techniques on four separate papers and then the surgeon was blindly chose one paper for each patient. Four pediatric surgeons had experience in ARMs techniques were performed the repair.
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| Name | Affiliation | Role |
|---|---|---|
| Sarah Abdelmohsen | Aswan University | Principal Investigator |
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| ID | Term |
|---|---|
| D000071056 | Anorectal Malformations |
| ID | Term |
|---|---|
| D004065 | Digestive System Abnormalities |
| D004066 | Digestive System Diseases |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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| PSARP | Procedure | Posterior sagittal anorectoplasty |
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| Classic ASARP | Procedure | Anterior Sagittal anorectoplasty |
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| Modified ASARP | Procedure | External anal sphincter preservation |
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| 1year |