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Eur J Pediatr Surg 2016; 26(04): 336-339
DOI: 10.1055/s-0035-1552569
Original Article
Georg Thieme Verlag KG Stuttgart · New York

The Surgical Management of H-Type Rectovestibular Fistula: A Novel Modification

Ye-ming Wu
1   Department of Pediatric Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
2   Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai Institute for Pediatric Research, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
*   The first two authors contributed equally to this work.
,
Cheng-dong Wang
1   Department of Pediatric Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
*   The first two authors contributed equally to this work.
,
Fan Lv
1   Department of Pediatric Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Chi Zhang
1   Department of Pediatric Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Zhi-long Yan
3   Department of Pediatric Surgery, Shanghai Children's Medical Center, Shanghai, China
› Author Affiliations
Further Information

Publication History

01 February 2015

30 March 2015

Publication Date:
29 May 2015 (online)

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Abstract

Introduction H-type rectovestibular fistulas could be rare anorectal malformations or acquired diseases secondary to perianal infection. Various surgical procedures have been described in the literature, however the problem of recurrence still remains to be solved. We describe a novel modified surgical procedure and outcome in the management of these patients.

Methods From 1999 to 2014, 14 patients who had an H-type rectovestibular fistula underwent the same surgical procedure performed by the same surgical team. Rectal-vestibular pull-through inside-out and endorectal mucosal advancement flap was used, including circumferential incision of the fistula from the opening on the rectal side, pulling the fistula inside-out, ligating the fistula, and mobilizing a rectal mucosal flap to cover the internal opening.

Results All the patients have been followed-up for 12 months to 15 years with no recurrences and no incontinence.

Conclusion Our surgical management is a simple, safe, and probable choice for the treatment of H-type rectovestibular fistula with favorable outcomes.

Keywords

H-type rectovestibular fistula - anorectal malformation - modified operative technique
 

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