Su Fan,Yang Heying,Yue Ming,et al.Clinical efficacies of congenital anorectal malformation with rectovestibular fistula in girls: a Meta-analysis[J].Journal of Clinical Pediatric Surgery,,21():958-967.[doi:10.3760/cma.j.cn101785-202110006-011]
Clinical efficacies of congenital anorectal malformation with rectovestibular fistula in girls: a Meta-analysis
- Keywords:
- Anorectal Malformations; Surgery; Anus; Imperforate; Surgery; Treatment Outcome; Infant; Newborn
- Abstract:
- Objective To evaluate the surgical efficacy of anal dimple anorectoplasty (ADARP),anterior sagittal anorectoplasty (ASARP) and posterior sagittal anorectoplasty (PSARP) for congenital anorectal malformation with rectovestibular fistula through a Meta-analysis.Methods From 2002 to 2020,a literature search was performed within the databases of Wanfang,CNKI,PubMed and Web of Science regarding the treatment of congenital anorectal malformation with rectovestibular fistula by ASARP,PSARP and ADARP.Meta-analysis of literature data was performed with Stata 13.0,including the incidence of short-term postoperative complications (wound infection,wound dehiscence,rectal retraction,anal stricture,rectal prolapse & fistula recurrence) and long-term complications (constipation and soiling).Results In the end,a total of 21 articles with 776 effective cases were retrieved.There were ADARP(n=4),ASARP (n=8) and PSARP (n=11).ADARP was superior to the other two in the following aspects:incidence of wound infection [ADARP:4%,95%CI:-0.02 to 0.10;ASARP:17%,95%CI:0.11 to 0.22;PSARP:9%,95%CI:0.04-0.14],incidence of rectal retraction[ADARP:4%,95%CI:-0.02-0.09;ASARP:5%,95%CI:0.01-0.10;PSARP:4%,95%CI:-0.04-0.13],incidence of rectal prolapse [ADARP:4%,95%CI:-0.04-0.11;ASARP:8%,95%CI:0.03-0.13;PSARP:8%,95%CI:0.05-0.12];incidence of postoperative constipation[ADARP:8%(95%CI:-0.03-0.18),ASARP:18% (95%CI:0.10-0.26),PSARP:17% (95%CI:0.10-0.23)],incidence of soiling[ADARP 4% (95%CI:-0.04-0.11),ASARP 13% (95%CI:0.05-0.21),PSARP 17% (95%CI:0.10-0.25)].For the occurrence of anal stenosis and fistula recurrence,ADARP is slightly inferior to the other two procedures.Conclusion As compared with anterior and posterior sagittal anoplasty,anal dimple anorectoplasty is efficacious for congenital anal atresia with rectovestibular fistula postoperative incision infection,rectal retraction,rectal prolapse and distal complications.The incidence of early complications is lower.However,the incidence of anal stenosis and fistula recurrence has remained slightly higher.
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Memo
收稿日期:2021-10-10。
通讯作者:杨合英,Email:yanghy130@163.com