Perineal Groove: An Anorectal Malformation Network, Consortium Study

Inbal Samuk, Eva E. Amerstorfer, Maria Fanjul, Barbara D. Iacobelli, Gabriele Lisi, Paola Midrio, Anna Morandi, Eberhard Schmiedeke, Pernilla Stenstrom, Christien Sleeboom

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.

Original languageEnglish
Pages (from-to)207-212
Number of pages6
JournalJournal of Pediatrics
Volume222
DOIs
Publication statusPublished - Jul 2020

Keywords

  • anorectal malformations
  • congenital anomaly
  • groove
  • neonatal
  • perineal sulcus
  • perineum

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Samuk, I., Amerstorfer, E. E., Fanjul, M., Iacobelli, B. D., Lisi, G., Midrio, P., Morandi, A., Schmiedeke, E., Stenstrom, P., & Sleeboom, C. (2020). Perineal Groove: An Anorectal Malformation Network, Consortium Study. Journal of Pediatrics, 222, 207-212. https://doi.org/10.1016/j.jpeds.2020.03.026