Results of treatment of fifty children with persistent cloaca in one center
- 作者: Mokrushina O.G.1,2, Shumikhin V.S.1,2, Levitskaya M.V.2, Chundokova M.A.1,2, Halafov R.V.1,2, Shugina J.V.1,2, Petrova L.V.2, Koshko O.V.2, Emirbekova S.K.2
-
隶属关系:
- Pirogov Russian National Medical University
- Filatov Children’s Hospital
- 期: 卷 11, 编号 3 (2021)
- 页面: 315-324
- 栏目: Original Study Articles
- URL: https://bakhtiniada.ru/2219-4061/article/view/123567
- DOI: https://doi.org/10.17816/psaic985
- ID: 123567
如何引用文章
全文:
详细
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 Müllerian 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.
作者简介
Olga Mokrushina
Pirogov Russian National Medical University; Filatov Children’s Hospital
编辑信件的主要联系方式.
Email: mokrushina@yandex.ru
ORCID iD: 0000-0003-4444-6103
SPIN 代码: 5998-7470
Deputy Chief Physician for Surgery, professor of Department of Pediatric Surgery
俄罗斯联邦, 15, Sadovaya-Kudrinskaya str., 103001, Moscow; MoscowVasiliy Shumikhin
Pirogov Russian National Medical University; Filatov Children’s Hospital
Email: pennylane@yandex.ru
ORCID iD: 0000-0001-9477-8785
SPIN 代码: 6405-8928
head of newborn department, assistant professor
俄罗斯联邦, 15, Sadovaya-Kudrinskaya str., 103001, Moscow; MoscowMarina Levitskaya
Filatov Children’s Hospital
Email: urolog@neosurg.ru
ORCID iD: 0000-0002-9838-9493
pediatric surgery
俄罗斯联邦, 15, Sadovaya-Kudrinskaya str., 103001, MoscowMadina Chundokova
Pirogov Russian National Medical University; Filatov Children’s Hospital
Email: cmadina@yandex.ru
ORCID iD: 0000-0002-5080-4838
SPIN 代码: 1122-0394
professor of Department of Pediatric Surgery, pediatric surgery
俄罗斯联邦, 15, Sadovaya-Kudrinskaya str., 103001, Moscow; MoscowRashid Halafov
Pirogov Russian National Medical University; Filatov Children’s Hospital
Email: drrash777@gmail.com
ORCID iD: 0000-0001-7998-5639
pediatric surgery, assistent professor
俄罗斯联邦, 15, Sadovaya-Kudrinskaya str., 103001, Moscow; MoscowJulia Shugina
Pirogov Russian National Medical University; Filatov Children’s Hospital
Email: doctorshugina@gmail.com
ORCID iD: 0000-0003-0982-8106
pediatric surgery, graduate student
俄罗斯联邦, 15, Sadovaya-Kudrinskaya str., 103001, Moscow; MoscowLubov Petrova
Filatov Children’s Hospital
Email: celine1988@mail.ru
ORCID iD: 0000-0001-8727-5514
pediatric surgery
俄罗斯联邦, 15, Sadovaya-Kudrinskaya str., 103001, MoscowOlga Koshko
Filatov Children’s Hospital
Email: kas321@gmail.com
ORCID iD: 0000-0002-6946-938X
anesthetist
俄罗斯联邦, 15, Sadovaya-Kudrinskaya str., 103001, MoscowSvetlana Emirbekova
Filatov Children’s Hospital
Email: aisha.shabanova@yandex.ru
ORCID iD: 0000-0003-0334-3255
anesthetist
俄罗斯联邦, 15, Sadovaya-Kudrinskaya str., 103001, Moscow参考
- Levitt MA, Peña A. Cloacal malformations: lessons learned from 490 cases. J Pediatric Surg. 2010;19(2):128–138. doi: 10.1053/j.sempedsurg.2009.11.012
- Abdelhamid A, Bassiouny AZ. Persistent cloaca: persistence of the challenge. Annals of Pediatric Surgery. 2020;16:1–7. doi: 10.1186/s43159-019-0010
- Otamuradov FA, Ergashev NSh. Persisting cloaca in girls. The issues of diagnostics and surgical correction. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(4):108–111. (In Russ.)
- Kirgizov IV, Minaev SV, Gladkij AP, et al. Multicenter research of persistent cloacal malformation surgery in children. Medical news of North Caucasus. 2014;9(4):295–299. (In Russ.) doi: 10.14300/mnnc.2014.09083
- Versteegh HP, Sutcliffe JR, Sloots CE, et al. Postoperative complications after reconstructive surgery for cloacal malformations: a systematic review. Tech Coloproctol. 2015;19(4):201–207. doi: 10.1007/s10151-015-1265-x
- Mokrushina OG, Shchapov NF, Menovshchikova LB, et al. Radikal’naya korrektsiya persistiruyushchei kloaki metodom total’noi urogenital’noi mobilizatsii u devochki 3-kh mesyatsev. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2013;3(4):108–111. (In Russ.)
- Singh Bal H, Sen S, Sam C, et al. Urogenital management in cloaca: An alternative approach. J Indian Assoc Pediatr Surg. 2017;22(2):108–113. doi: 10.4103/0971-9261.202683
- Liem NT, Quynh TA. Laparoscopic rectal pull-through for persistent cloaca: an easier approach for a complex anomaly. J Pediatr Surg. 2012;47(4):815–818. doi: 10.1016/j.jpedsurg.2012.02.004
- Hendren WH. Cloacal malformations: experience with 105 cases. J Pediatr Surg. 1992;27(7):890–901. doi: 10.1016/0022-3468(92)90393-L
- Versteegh HP, Sloots CEJ, de Jong JR, et al. Early versus late reconstruction of cloacal malformations: The effects on postoperative complications and long-term colorectal. J Pediatr Surg. 2014;49(4):556–559. doi: 10.1016/j.jpedsurg.2013.10.028
- Cho M-J, Kim T-H, Kim D-Y, et al. Clinical experience with persistent cloaca. J Korean Surg Soc. 2011;80(6):431–436. doi: 10.4174/jkss.2011.80.6.431
- Adamyan LV, Darenkov SP, Shelygin YuA, et al. A clinical case of congenital cloacal anomaly of pelvic organs. Obstetrics and Gynecology. 2012;(8-1):60–63. (In Russ.)
- Halleran DR, Thompson B, Fuchs M, et al. Urethral length in female infants and its relevance in the repair of cloaca. J Pediatric Surgery. 2019;54(2):303–306. doi: 10.1016/j.jpedsurg.2018.10.094
补充文件
