Caldwell Brian T, Wilcox Duncan T
Department of Pediatric Urology, Children׳s Hospital Colorado, 13123 East, 16th Ave Box 463, Aurora, Colorado 80045.
Department of Pediatric Urology, Children׳s Hospital Colorado, 13123 East, 16th Ave Box 463, Aurora, Colorado 80045.
Semin Pediatr Surg. 2016 Apr;25(2):108-11. doi: 10.1053/j.sempedsurg.2015.11.010. Epub 2015 Nov 10.
Cloacal anomalies are the most complex and severe form of congenital anorectal malformations (ARM) and urogenital malformations, and it has been well documented that increased severity of ARM leads to worse outcomes. While short-term data on persistent cloaca are available, a paucity of data on long-term outcomes exists, largely because of a lack of uniform terminology, inclusion with other ARM and evolution of the operative technique. On comprehensive review of the published literature on long-term urological outcomes in patients with cloacal anomalies, we found a significant risk of chronic kidney disease and incontinence, however, with improvements in surgical technique, outcomes have improved. Continence often requires intermittent catheterization and in some cases, bladder augmentation. The complexity of cloacal malformations and associated anomalies make long-term multidisciplinary follow-up imperative.
泄殖腔畸形是先天性肛门直肠畸形（ARM）和泌尿生殖系统畸形中最复杂、最严重的形式，并且已有充分记录表明，ARM严重程度增加会导致更差的预后。虽然有关于持续性泄殖腔的短期数据，但长期预后的数据却很匮乏，这主要是由于缺乏统一的术语、与其他ARM的合并情况以及手术技术的演变。在全面回顾已发表的关于泄殖腔畸形患者长期泌尿系统预后的文献时，我们发现存在慢性肾病和尿失禁的重大风险，不过，随着手术技术的改进，预后已有所改善。控尿通常需要间歇性导尿，在某些情况下还需要膀胱扩大术。泄殖腔畸形及相关畸形的复杂性使得长期多学科随访势在必行。
