Current practice regarding the diagnosis and treatment of anorectal malformations in female patients: a multicenter questionnaire survey in Japan.

IF 1.7 4区医学 Q2 SURGERY Surgery Today Pub Date : 2024-12-08 DOI:10.1007/s00595-024-02968-x

Toshio Harumatsu, Masakazu Murakami, Ayaka Nagano, Koshiro Sugita, Tetsuya Ishimaru, Akihiro Fujino, Mitsuyuki Nakata, Shigeyoshi Aoi, Hideki Soh, Yoshiaki Kinoshita, Keiichi Uchida, Takeshi Hirabayashi, Yasushi Fuchimoto, Hideaki Okajima, Takeo Yonekura, Tsugumichi Koshinaga, Minoru Yagi, Hiroshi Matsufuji, Seiichi Hirobe, Masaki Nio, Shigeru Ueno, Jun Iwai, Tatsuo Kuroda, Satoshi Ieiri

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Abstract

Purpose: This study aimed to investigate the current practices in the diagnosis and surgical management of anorectal malformations (ARMs) in female patients in Japan, specifically focusing on anovestibular fistula (AVF), rectovaginal fistula (RVF), and persistent cloaca (PC).

Methods: An anonymous online survey was conducted with 61 institutional members of the Japanese Study Group for Anorectal Anomalies.

Results: Sixty-one institutions (100%) completed the survey. For AVF, fistulography/vaginography was the most common diagnostic method (98.4%), and anorectoplasty was usually performed at 3-6 months of age (86.9%) using anterior sagittal anorectoplasty (62.3%) or anal transposition (39.3%). Distal colostography (100%), MRI (71.7%), and cystscopy/urethroscopy/vaginoscopy (83.3%) were commonly used for PC. Patients with PC underwent anorectoplasty at 7-24 months (93.3%), predominantly posterior sagittal anorecto-urethro-vaginoplasty (PSARUVP) (41.7%), or laparoscopy-assisted anorectoplasty (LAARP) (43.3%). A subgroup analysis revealed that PSARUVP used blunt dissection (70.0% vs. 28.6%, p < 0.05) and visual confirmation by opening the rectum (80.0% vs. 4.8%, p < 0.001) significantly more often than LAARP for PC.

Conclusion: This nationwide survey revealed distinct patterns in the diagnostic timing and surgical approaches for female ARMs in Japan, highlighting the varying preferences in fistula management techniques across different types of malformations.

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女性肛肠畸形的诊断和治疗现状：日本一项多中心问卷调查。

目的：本研究旨在探讨日本女性肛肠畸形（ARMs）的诊断和手术治疗现状，特别是肛门前庭瘘（AVF）、直肠阴道瘘（RVF）和持续性泄殖腔（PC）。方法：对日本肛肠异常研究组的61个机构成员进行匿名在线调查。结果：61所院校（100%）完成调查。对于AVF，瘘管造影/阴道造影是最常见的诊断方法（98.4%），肛肠成形术通常在3-6月龄时进行（86.9%），采用前矢状肛肠成形术（62.3%）或肛门转位（39.3%）。远端结肠造影（100%）、MRI（71.7%）和膀胱镜/尿道镜/阴道镜（83.3%）是PC的常用检查方法。PC患者在7-24个月时接受了肛肠成形术（93.3%），主要是后矢状肛肠-尿道-阴道成形术（PSARUVP）（41.7%）或腹腔镜辅助肛肠成形术（LAARP）（43.3%）。一项亚组分析显示，PSARUVP使用钝性解剖（70.0% vs. 28.6%）。结论：这项全国性调查揭示了日本女性ARMs的诊断时间和手术入路的不同模式，突出了不同类型畸形对瘘管管理技术的不同偏好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.