Perineal Groove: An Anorectal Malformation Network, Consortium Study

Research output: Contribution to journalArticle

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 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.

Details

Authors
  • Inbal Samuk
  • Eva E. Amerstorfer
  • Maria Fanjul
  • Barbara D. Iacobelli
  • Gabriele Lisi
  • Paola Midrio
  • Anna Morandi
  • Eberhard Schmiedeke
  • Pernilla Stenstrom
  • Christien Sleeboom
Organisations
External organisations
  • Schneider Children's Medical Center of Israel
  • Tel-Aviv University
  • Medical University of Graz
  • Hospital Gregorio Maranon
  • Bambino Gesù Children’s Hospital
  • University of Chieti-Pescara
  • Maggiore Hospital Policlinico
  • Klinikum Bremen-Mitte
  • Skåne University Hospital
  • Treviso Hospital
  • University of Amsterdam
  • Amsterdam UMC - Vrije Universiteit Amsterdam
  • Vrije Universiteit Amsterdam
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Pediatrics

Keywords

  • anorectal malformations, congenital anomaly, groove, neonatal, perineal sulcus, perineum
Original languageEnglish
Pages (from-to)207-212
Number of pages6
JournalJournal of Pediatrics
Volume222
Publication statusPublished - 2020
Publication categoryResearch
Peer-reviewedYes