Basu Ashoke Kumar, Basu Kalyani Saha, Bhaumik Kuntal, Basu Jyotsna, Aanad Abhishek
Department of Pediatric Surgery, Institute of Child Health, Kolkata, India.
Department of Pediatric Surgery, Nil Ratan Sarkar Medical College and Hospital, Kolkata, India.
J Indian Assoc Pediatr Surg. 2024 Jul-Aug;29(4):334-339. doi: 10.4103/jiaps.jiaps_239_23. Epub 2024 Jul 6.
Reconstruction of a cloacal defect in a girl is often difficult and complicated.[1] This is most often done either by the sacro-perineal route or through the posterior sagittal route.[2] The procedures may involve total mobilization of the cloaca with or without the creation of a lower vagina with the help of a loop of vascularized bowel.[3] In our approach, such defects can be corrected using the lower anorectum for the creation of a lower vagina and abdominoperineal pull-through of the proximal divided bowel. This method can be used both in short and long common channel cloaca.
We have used this procedure in one patient of posterior cloaca and four patients of anterior cloaca. These operations were done in patients of 1 year and 6 months to 4 years. Only one patient is waiting for the closure of the colostomy.
In all the cases, the urethra, the vagina, and the anus were successfully separated.
This operation restores normal pelvic anatomy and physiology with minimal mutilation of the pelvic floor.
女童泄殖腔缺损的重建手术通常困难且复杂。[1] 最常通过骶会阴途径或后矢状途径进行。[2] 手术可能包括在有或没有带血管蒂肠袢辅助下完全游离泄殖腔以形成低位阴道。[3] 在我们的手术方法中，此类缺损可利用低位直肠来形成低位阴道，并通过腹会阴拖出近端离断肠管进行修复。该方法可用于短和长共同通道型泄殖腔。
我们已将此手术应用于1例后泄殖腔患者和4例前泄殖腔患者。这些手术在年龄为1岁6个月至4岁的患者中进行。仅1例患者等待结肠造口关闭。
在所有病例中，尿道、阴道和肛门均成功分离。
该手术能以对盆底最小限度的毁损恢复正常的盆腔解剖结构和生理功能。
