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Perineal Groove : An Anorectal Malformation Network, Consortium Study

Samuk, Inbal ; Amerstorfer, Eva E. ; Fanjul, Maria ; Iacobelli, Barbara D. ; Lisi, Gabriele ; Midrio, Paola ; Morandi, Anna ; Schmiedeke, Eberhard ; Stenstrom, Pernilla LU and Sleeboom, Christien (2020) In Journal of Pediatrics 222. p.207-212
Abstract

Objective: To review the Anorectal Malformation Network experience with perineal groove (PG) focusing on its clinical characteristics and management. Study design: Data on patients with PG managed at 10 participating Anorectal Malformation Network centers in 1999-2019 were collected retrospectively by questionnaire. Results: The cohort included 66 patients (65 females) of median age 1.4 months at diagnosis. The leading referral diagnosis was anal fissure (n = 20 [30.3%]): 23 patients (34.8%) had anorectal malformations. Expectant management was practiced in 47 patients (71.2%). Eight (17%) were eventually operated for local complications. The median time to surgery was 14 months (range, 3.0-48.6 months), and the median age at surgery... (More)

Objective: To review the Anorectal Malformation Network experience with perineal groove (PG) focusing on its clinical characteristics and management. Study design: Data on patients with PG managed at 10 participating Anorectal Malformation Network centers in 1999-2019 were collected retrospectively by questionnaire. Results: The cohort included 66 patients (65 females) of median age 1.4 months at diagnosis. The leading referral diagnosis was anal fissure (n = 20 [30.3%]): 23 patients (34.8%) had anorectal malformations. Expectant management was practiced in 47 patients (71.2%). Eight (17%) were eventually operated for local complications. The median time to surgery was 14 months (range, 3.0-48.6 months), and the median age at surgery was 18.3 months (range, 4.8-58.0 months). In the 35 patients available for follow-up of the remaining 39 managed expectantly, 23 (65.7%) showed complete or near-complete self-epithelization by a mean age 15.3 months (range, 1-72 months) and 4 (11.4%) showed partial self-epithelization by a mean age 21 months (range, 3-48 months). Eight patients showed no resolution (5 were followed for ≤3 months). Nineteen patients (28.7%) were primarily treated with surgery. In total, 27 patients were operated. Dehiscence occurred in 3 of 27 operated patients (11.1%). Conclusions: PG seems to be an underestimated anomaly, frequently associated with anorectal malformations. Most cases heal spontaneously; therefore, expectant management is recommended. When associated with anorectal malformations requiring reconstruction, PG should be excised in conjunction with the anorectoplasty.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
anorectal malformations, congenital anomaly, groove, neonatal, perineal sulcus, perineum
in
Journal of Pediatrics
volume
222
pages
6 pages
publisher
Academic Press
external identifiers
  • pmid:32586525
  • scopus:85086589220
ISSN
0022-3476
DOI
10.1016/j.jpeds.2020.03.026
language
English
LU publication?
yes
id
58cfab15-4eb0-400e-98c0-8d154c3f55a1
date added to LUP
2020-07-02 12:42:12
date last changed
2020-07-03 03:00:02
@article{58cfab15-4eb0-400e-98c0-8d154c3f55a1,
  abstract     = {<p>Objective: To review the Anorectal Malformation Network experience with perineal groove (PG) focusing on its clinical characteristics and management. Study design: Data on patients with PG managed at 10 participating Anorectal Malformation Network centers in 1999-2019 were collected retrospectively by questionnaire. Results: The cohort included 66 patients (65 females) of median age 1.4 months at diagnosis. The leading referral diagnosis was anal fissure (n = 20 [30.3%]): 23 patients (34.8%) had anorectal malformations. Expectant management was practiced in 47 patients (71.2%). Eight (17%) were eventually operated for local complications. The median time to surgery was 14 months (range, 3.0-48.6 months), and the median age at surgery was 18.3 months (range, 4.8-58.0 months). In the 35 patients available for follow-up of the remaining 39 managed expectantly, 23 (65.7%) showed complete or near-complete self-epithelization by a mean age 15.3 months (range, 1-72 months) and 4 (11.4%) showed partial self-epithelization by a mean age 21 months (range, 3-48 months). Eight patients showed no resolution (5 were followed for ≤3 months). Nineteen patients (28.7%) were primarily treated with surgery. In total, 27 patients were operated. Dehiscence occurred in 3 of 27 operated patients (11.1%). Conclusions: PG seems to be an underestimated anomaly, frequently associated with anorectal malformations. Most cases heal spontaneously; therefore, expectant management is recommended. When associated with anorectal malformations requiring reconstruction, PG should be excised in conjunction with the anorectoplasty.</p>},
  author       = {Samuk, Inbal and Amerstorfer, Eva E. and Fanjul, Maria and Iacobelli, Barbara D. and Lisi, Gabriele and Midrio, Paola and Morandi, Anna and Schmiedeke, Eberhard and Stenstrom, Pernilla and Sleeboom, Christien},
  issn         = {0022-3476},
  language     = {eng},
  pages        = {207--212},
  publisher    = {Academic Press},
  series       = {Journal of Pediatrics},
  title        = {Perineal Groove : An Anorectal Malformation Network, Consortium Study},
  url          = {http://dx.doi.org/10.1016/j.jpeds.2020.03.026},
  doi          = {10.1016/j.jpeds.2020.03.026},
  volume       = {222},
  year         = {2020},
}