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https://doi.org/10.14300/mnnc.2014.09083

Multicenter research of persistent cloacal malformation surgery in children

[Original research] [Surgery]
Igor Kirgizov; Sergey Minaev; Alexander Gladkij; Ilya Shishkin; Artem Shakhtarin; Maxim Aprosimov; Sergey Timofeev; Igor Gerasimenko;

Among 22 children aged 1,2±0,1 years old with persistent cloacal malformation 18,2 % of the patients had an isolated malformation while the rest of the children displayed a combination of cloaca with a urinary system abnormality (72,8 %), a cardiovascular system abnormality (41 %) and a locomotor system abnormality (31,8 %). 9 patients (40,9 %) had a total cloacal canal smaller than 3 cm, 13 children (59,1 %) had a total cloacal canal larger than 3 cm. The choice of the surgical method depended on the cloacal canal length and the «maturity» of vagina walls. 5 children (22,7 %) underwent posterior sagittal proctovaginaurethroplasty; 4 children (18,2 %) got perineal proctovaginaurethroplasty with laparoscopic support and partial urogenital mobilization; 3 children (13,6 %) underwent total urogenital mobilization; 10 children (45,5 %) underwent abdominoperineal proctovaginaurethroplasty with the replacement of vagina for colon or small intestine. During the early postoperative period, most children had no complications. The mortality rate amounted to 4,5 %. The treatment efficiency was assessed at the age of 3–7 years old. The children with a shorter cloacal canal displayed better results of the treatment than those with a longer cloacal canal, with fecal matter retention registered in 66,7 % and 41,7 % of the patients, respectively; urine retention was observed in 77,8 % and 75,0 % of the children, respectively.

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Keywords: cloacal malformations, children, surgical treatment, resultsurgical treatment, result