Gastrointestinal ramifications of the cloacal exstrophy complex: a 44-year experience

Journal of Pediatric Surgery
David SawayaJ P Gearhart

Abstract

Cloacal exstrophy is a rare and complex congenital anomaly requiring coordination among multiple pediatric subspecialties. There is currently no consensus regarding the fate and function of the hindgut, which plays an integral role in patients' long-term gastrointestinal health and genitourinary reconstruction. A retrospective chart review was performed evaluating 77 patients with cloacal exstrophy treated during the previous 44 years at our institution. Seventy-seven patients with cloacal exstrophy were treated between 1965 and 2008. Sixty-five were white, 6 were African American, 3 were Asian, and 3 were Hispanic. Genotypes included 44 XY, 32 XX, and 1 XYY. Fifty-one were reared as females and 26 as males. The hindgut length was 2 to 5 cm in 11 patients, 6 to 10 cm in 18 patients, 11 to 15 cm in 6 patients, 16 to 20 cm in 7 patients, and greater than 20 cm in 2 patients. The hindgut length was unknown in 33 patients. Forty-seven patients had tubularization of the cecal plate with an end colostomy, and 30 patients had an ileostomy placed for bowel diversion purposes. Four patients had short gut syndrome. Thirty-one patients had genitourinary reconstruction, 12 using small bowel and 19 using colon. Eight patients had hindgut pu...Continue Reading

References

Apr 1, 1991·Journal of Pediatric Surgery·R R RickettsB H Broecker
Jan 1, 1970·American Journal of Surgery·E S Tank, S M Lindenauer
Aug 4, 2007·Pediatric Surgery International·Masaaki OshitaAtsuyuki Yamataka

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Citations

Aug 11, 2012·Pediatric Surgery International·Andrea BischoffAlberto Peña
May 13, 2014·Pediatric Surgery International·Andrea BischoffAlberto Peña
Jan 18, 2016·Journal of Pediatric Surgery·Seth D GoldsteinJohn P Gearhart
Sep 21, 2011·Journal of Pediatric Surgery·Andrew A StecJohn P Gearhart
Apr 2, 2011·Seminars in Pediatric Surgery·Timothy M Phillips
Apr 2, 2011·Seminars in Pediatric Surgery·David Sawaya, John P Gearhart
Oct 18, 2011·American Journal of Medical Genetics. Part C, Seminars in Medical Genetics·Marcia L FeldkampJohn C Carey
Jul 15, 2015·Journal of Indian Association of Pediatric Surgeons·Rajiv ChadhaArchana Puri
Jul 2, 2016·Journal of Pediatric Urology·K D SusonJ P Gearhart
Jun 9, 2016·American Journal of Medical Genetics. Part a·Adeline JacquinetAnna Lehman
Oct 18, 2011·American Journal of Medical Genetics. Part C, Seminars in Medical Genetics·Eva Bermejo-SánchezMaría-Luisa Martínez-Frías
Mar 21, 2018·Journal of Pediatric Surgery·Mahir MarufJohn P Gearhart

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