PRIMARY PROCEDURE FOR RECTO-VESTIBULAR FISTULA IN FEMALE CHILDREN: AN EARLY EXPERIENCE AT KHYBER TEACHING HOSPITAL PESHAWAR.

Abstract

Abstract

Background: Recto-vestibular fistula is the most common variant of Anorectal malformation in female children. Traditional management of this entity is a three stages procedure i.e. colostomy, PSARP, and colostomy closure. The aim of this study was to manage these patients by a primary definitive surgical procedure without colostomy and to know the procedure feasibility, cost effectiveness, complications, safety and short term functional outcome.

Materials and method: 

Results: A total of 40 female children fulfilling inclusion criteria of the study were included. Age range was 28 days to 8 months. No mortality noted during study period. Mean operative time was 50±15 minutes. Mean Hospital stay in days was 6.65.Procedure related complications were recorded as wound infection 5(12.5%), wound dehiscence 1 (2.5%), posterior vaginal wall injury 5(12.5%).Overall parental satisfaction regarding procedure was 92.5%.

Conclusion: Primary single stage procedure either by PSARP or ASARP  for the correction of Rectovestibular fistula in female children of ARM was less traumatic to children, acceptable to their parents, having cost effectiveness for poor socioeconomic parents and encouraging  functional outcome.