Single-Stage versus Three-Stage Repair in Anorectal Malformations with Rectovestibular Fistula: A Prospective Observational Study

Authors

  • Kashyap Pandya
  • Rajesh Patolia
  • Ananyaa Pandya
  • Bemat Gulamhusen Mohammed

Keywords:

Rectovestibular fistula, Single-stage repair, Three-stage repair, Fecal continence, Pediatric surgery

Abstract

Background: Rectovestibular fistula is the most common subtype of anorectal malformation in females. While the traditional three-stage repair remains the standard in many settings, single-stage repair is increasingly considered as a viable alternative in selected patients.

Objective: To compare the short-term complications, long-term functional outcomes, and hospital stay between single-stage and three-stage repair in female patients with rectovestibular fistula.

Methods: This prospective observational study included 30 female patients treated at KGP Children Hospital, Vadodara, between January 2015 and December 2024. Ten patients underwent single-stage repair, while twenty underwent traditional three-stage repair. Outcomes assessed included postoperative complications (wound infection, anal stenosis, perineal excoriation), fecal continence, constipation, and total hospital stay. Statistical comparisons were made using chi-square and t-tests.

Results: Wound infection was more frequent in the single-stage group (40%) than in the three-stage group (5%). Good fecal continence was achieved in 70% of single-stage patients versus 55% in the three-stage group. Severe constipation was more prevalent in the three-stage group (35%). Mean hospital stay was significantly shorter in the single-stage group (4.8 ± 1.03 days) compared to the three-stage group (11.85 ± 1.81 days, p< 0.001).

Conclusion: Single-stage repair for rectovestibular fistula offers comparable functional outcomes to the three-stage approach and significantly reduces hospitalization time. With proper case selection, it may be a safe and cost-effective alternative in resource-limited settings.

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References

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Published

2025-05-22

How to Cite

1.
Pandya K, Patolia R, Pandya A, Mohammed BG. Single-Stage versus Three-Stage Repair in Anorectal Malformations with Rectovestibular Fistula: A Prospective Observational Study. J Neonatal Surg [Internet]. 2025May22 [cited 2025Oct.1];14(26S):434-40. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/6306

Issue

Vol. 14 No. 26S (2025): Journal of Neonatal Surgery

Section

Original Article

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