Advances in pediatric surgery

Korean Association of Pediatric Surgeons (대한소아외과학회)
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Anterior Sagittal Transrectal Approach (ASTRA) for Urethrovaginal Fistula after Total Repair of Persistent Cloaca - 1 Case Report -

잔존 총배설강 기형 수술 후 발생한 요도-질 누공에 대한 전방 시상 경직장적 접근 술식 (Anterior Sagittal Transrectal Approach, ASTRA) 1 례보고

  • Kim, Seong-Min (Division of Pediatric Surgery, Department of Surgery, Yonsei University College of Medicine) ;
  • Kim, Chang-Woo (Division of Pediatric Surgery, Department of Surgery, Yonsei University College of Medicine) ;
  • Kim, Byoung-Kyu (Division of Pediatric Surgery, Department of Surgery, Yonsei University College of Medicine) ;
  • Oh, Jung-Tak (Division of Pediatric Surgery, Department of Surgery, Yonsei University College of Medicine) ;
  • Han, Seok-Joo (Division of Pediatric Surgery, Department of Surgery, Yonsei University College of Medicine)
  • 김성민 (연세대학교 의과대학 외과학 교실, 세브란스 어린이병원 소아외과) ;
  • 김창우 (연세대학교 의과대학 외과학 교실, 세브란스 어린이병원 소아외과) ;
  • 김병규 (연세대학교 의과대학 외과학 교실, 세브란스 어린이병원 소아외과) ;
  • 오정탁 (연세대학교 의과대학 외과학 교실, 세브란스 어린이병원 소아외과) ;
  • 한석주 (연세대학교 의과대학 외과학 교실, 세브란스 어린이병원 소아외과)
  • Received : 2007.03.16
  • Accepted : 2007.05.28
  • Published : 2007.06.30
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Abstract

The authors applied anterior sagittal transrectal apporach (ASTRA) for the repair of urethrovaginal fistula which developed after total repair of persistent cloaca. The patient had been diagnosed to have persistent cloaca, double uterus and double vagina, and received PSARP, excision of right-side uterus and vagina, and left vaginal switch operation at 22 months old. After operation, the patient admitted several times due to frequent urinary tract infection and ectopic stone formation in bladder and neovagina. Urethro-neovaginal fistula was confirmed by cystoscopy and corrected with ASTRA. Postoperative voiding cystourethrogram showed no fistula tract. ASTRA showed improved surgical field, minimized ureterocystic damage, and preserved perirectal nerve due to limited incision of rectum.

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