[Total mobilization of the urogenital sinus in the treatment of cloaca].
Persistent cloaca is one of the most complex forms of anorectal malformation in girls. Surgical treatment is complicated and laborious especially when the common channel is long. The aim of this report was to emphasize the importance of the joint mobilization of the urogenital sinus after separation from the rectum. This maneuver avoids separation of the urinary tract from the genital tract and reduces operating time by more than 60 %. This is only possible when the common channel of the cloaca is less than 3 cm. We present the cases of two girls treated in the last 2 years with this technique. Operating time was significantly shortened to approximately 4 hours and the procedure was considerably simplified. The functional and cosmetic results were excellent. To obtain good results in the treatment of cloaca, a precise clinical and radiologist diagnosis must be made, surgical needs should be prioritized and the appropriate technique chosen. The best procedure for patients whose common channel is less than 3 cm is total mobilization of the urogenital sinus, subsequently sutured to the perineum, and placement the rectum within the anorectal sphincter complex.
López Alvarez-Buhilla
P
P
Servicio de Cirugía Pediátrica, Hospital de Cruces, Bilbao.
Torres Piedra
C
C
Blanco Bruned
J
J
Emparan G  De Salazar
C
C
Castro Laiz
C
C
D001003:Anal Canal / Q000002:abnormalities* / Q000601:surgery*; D002988:Cloaca; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D007223:Infant; D014564:Urogenital Abnormalities / Q000601:surgery*; D013519:Urogenital Surgical Procedures