Clinical experience with persistent cloaca
조민정, 김태훈, 김대연, 김성철, 김인구,
소속 상세정보
조민정 ( Cho Min-Jeng )
University of Ulsan College of Medicine Department of Pediatric Surgery
김태훈 ( Kim Tae-Hoon )
University of Ulsan College of Medicine Department of Pediatric Surgery
김대연 ( Kim Dae-Yeon )
University of Ulsan College of Medicine Department of Pediatric Surgery
김성철 ( Kim Seong-Chul )
University of Ulsan College of Medicine Department of Pediatric Surgery
김인구 ( Kim In-Koo )
University of Ulsan College of Medicine Department of Pediatric Surgery
KMID : 0371320110800060431
Abstract
Purpose: Persistent cloaca is one of the most severe types of anorectal malformation. Appropriate initial drainage is difficult due to their various malformations and hydrocolpos or dilated urinary bladder. Corrective surgery also differs among individual patients. We describe our experiences with the surgical management of children with persistent cloaca.
Methods: We retrospectively reviewed 16 children diagnosed with persistent cloaca at Asan Medical Center.
Results: Sixteen patients were managed in their neonatal period. Twelve patients had enlarged bladder or vagina at birth. Three patients, who did not undergo cystostomy or vaginostomy at first operation, had earlier complications after surgery or required drainage tube insertion. One patient who did not undergo hydrocolpos drainage died of sepsis and complications. Nine patients underwent corrective surgery; posterior sagittal anorectovaginourethroplasty using the Pena method. Three patients required additional operations due to complications after surgery.
Conclusion: Patients found to have anatomical malformations before colostomy, as well as hydrocolpos and bladder enlargement, require a vaginostomy with or without a cystostomy to reduce complications. Follow-up is required in patients with hydrocolpos and bladder enlargement to determine whether vaginal drainage improves dilated bladder. Continuous long-term follow-up examination is required to determine the long-term results of corrective surgery.
키워드
Persistent cloaca; Anorectal malformation; Hydrocolpos; Posterior sagittal anorectovaginourethroplasty
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