الفهرس 
EmbryologyOnly 14 pages are availabe for public view
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Abstract
Rectovestibular fistula is the most common type of anorectal malformation in females with average incidence worldwide is 1 in 5000 live births. A correct diagnosis and decision-making can be done in 90% to 95% in female babies on simple perineal inspection which shows a normal urethra, normal vagina and another opening in the vestibule. Management of rectovestibular fistula represent a matter of controversy, some prefer to do a diverting colostomy before the definitive operation, other go to single stage procedure without colostomy. Several surgical techniques have been described for the correction of this anomaly such as cutback procedure, anal transposition, posterior sagittal anorectoplasty (PSARP) and anterior sagittal anorectoplasty (ASARP). In this study, 24 female patients with rectovestibular fistula were studied after being classified into two groups. Group (1): Primary repair without colostomy (14 cases) prospectively. Group (2): Multistage repair (10 cases) retrospectively the last 10 cases operated in our hospital. There are two types of complications: -The complications related to the definitive technique (PSARP) which occurred in both groups and it was observed that the incidence of anal excoriations, Partial dehiscence and wound inflammation was higher in Group (1) than in Group (2). No complete dehiscence of the perineal wound or disruption of the perineal body was reported in both groups.the other hand, the complications related to colostomy and its closure were observed in Group (2) varying from mild complication as skin excoriation to sever one necessitating second surgical interference as incisional hernia. from this study, it was observed that primary repair of rectovestibular fistula is technically feasible and safe. It avoids the risk of complications related to colostomy, the risks of multiple anesthesias and reduces the economic and psychological burden to the family. This concept helped to avoid the occurrence of complications resulting from colostomy which should not be considered as a minor procedure and should be performed under supervision of senior staff. However it requires further studies with larger number of patients and longer follow-up period to draw more precise and final conclusions.