儿童肛管重复畸形2例并文献复习OA北大核心CSTPCD

Objective To explore the clinical characteristics and treatments of anal canal duplication(ACD)in children.Methods The relevant clinical data were retrospectively reviewed for two ACD children.More related cases were retrieved from the relevant Chinese and English literature reports of the databases of PubMed,Medline,Web of Science,CNKI and Wanfang from 1993 to 2022.Results Two neonates presented with sagittal anal orifice discovered by their mothers.There were no other associated anomalies.Fistulography revealed a tubular structure in two cases and proximal end of lumen communicated with rectum in case 2.Dis-section was performed via a posterior sagittal approach.Histological examination hinted at squamous epithelium with smooth muscle bundles.Both cases achieved excellent cosmetics with normal sphincter control.A total of 76 cases of ACD have been reported.There were 9 boys and 67 girls with a mean diagnostic age of 3.5(0-16)year;93％(71/76)of lesion were located at 6 o'clock behind anus;91％(69/76)was tubular and 9％(69/76)cystic.And 87％(66/76)were asymptomatic or mildly symptomatic(a mean age of 2.8 year);13％(10/76)developed presacral abscesses(a mean age of 7.7 year);33％(25/76)presented associated anomalies,including presacral mass(44％);70 children underwent surgical removal(perineal approach,n=34;posteri-or sagittal approach,n=36)and postoperative complications occurred(4％,3/70).Bowel function normalized during a mean follow-up period of 3.6 years(1 month to 19 years).Conclusions A clinical diagnosis of ACD should be suspected for an opening in posterior anal midline,particularly in girls.Associated anomalies should be ruled out.Early surgery is recommended.ACD removal via a posterior sagittal approach is both safe and ef-fective.