Preface
Congenital and acquired pediatric airway disease continues to pose significant challenges for many professional caretakers due to the complexity of these patients, often requiring careful diagnostic investigation and yet, urgent and demanding reconstructive treatments. The best time to correct any type of pediatric airway disease is at the first surgical procedure. In patients that have been treated improperly or with complicated outcomes, subsequent surgery is more difficult and may require multiple steps. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - February 15, 2016 Category: Pediatrics Authors: Jose Carlos Fraga, Peter C.W. Kim Source Type: research
Erratum to “The separation procedure” [Seminars in Pediatric Surgery 2015;24(5):231–236]
In Table 2 of this article, there has been a mistake of not including two cases. Please find below the corrected Table 2. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - December 1, 2015 Category: Pediatrics Authors: Edward M. Kiely, Lewis Spitz Source Type: research
The surgical treatment of cloaca
Similar to other anorectal malformations, cloaca also represents a spectrum of defects that goes from “benign” cloaca with a good functional prognosis that can be repaired with a relatively simple surgical technique, to very complex malformations with many anatomic variations that require different surgical maneuvers to be able to successfully reconstruct those patients.The group of patients born with a “benign” type of cloaca will have bowel and urinary control, will become sexually active and may get pregnant and deliver by cesarean section. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - November 11, 2015 Category: Pediatrics Authors: Andrea Bischoff Source Type: research
Congenital cloaca: Long-term follow-up results with emphasis on outcomes beyond childhood
Persistent cloaca remains a challenge for pediatric surgeons and urologists. Reconstructive surgery of cloacal malformations aims to repair the anorectum, urinary tract, and genital organs, and achieve fecal and urinary continence as well as functional genital tract capable for sexual activity and pregnancy. Unfortunately, even in most experienced hands these goals are not always accomplished. The endpoint of the functional development of bowel, urinary, and genital functions is the completion of patient’s growth and sexual maturity. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - November 9, 2015 Category: Pediatrics Authors: Risto J. Rintala Source Type: research
Pathology of cloaca Anomalies with case correlation
During the 4th week of human embryo development, a transient common channel known as a cloaca is formed from which three cavities with three external orifices arises. Persistence of the common channel/ cloaca in females occurs when the rectum, vagina, and urethra, fail to develop separately and instead drain via a single common channel into the perineum. In our previous institutional studies, Runck et al.1 compared human and mouse cloaca development and found early mis-patterning of the embryonic cloaca deranged hedgehog and Bone Morphogenetic Proteins (BMP) signaling. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - November 9, 2015 Category: Pediatrics Authors: Anita Gupta, Andrea Bischoff Source Type: research
Congenital cloaca: Long term follow-up results with emphasis on outcomes beyond childhood
Persistent cloaca remains a challenge for pediatric surgeons and urologists. Reconstructive surgery of cloacal malformations aims to repair the ano-rectum, urinary tract and genital organs, and achieve fecal and urinary continence as well as functional genital tract capable for sexual activity and pregnancy. Unfortunately, even in most experienced hands these goals are not always accomplished. The end point of the functional development of bowel, urinary and genital functions is the completion of patient‘s growth and sexual maturity. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - November 9, 2015 Category: Pediatrics Authors: Risto J. Rintala Source Type: research
Cloaca—Historical aspects and terminology
This is a summary of the milestones in the history of the treatment of cloacal malformations. It is based in a comprehensive literature review of the subject, from the early times, followed by a description of the evolution of the surgical maneuvers that were created, to be able to deal with the different anatomical variants of this complex congenital malformation. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - November 7, 2015 Category: Pediatrics Authors: Alberto Peña Source Type: research
Preface
Cloaca malformations are complex congenital defects that affect the gastro-intestinal and urogenital tracts. They occur more frequently than originally thought; as time has passed and the index of suspicion between health providers increased, the number of diagnoses increases. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - November 7, 2015 Category: Pediatrics Authors: Albert Pena Source Type: research
CLOACA.-Historical aspects and terminology
This is a summary of the milestones in the history of the treatment of cloacal malformations. It is based in a comprehensive literature review of the subject, from the early times; followed by a description of the evolution of the surgical maneuvers that were created, to be able to deal with the different anatomical variants of this complex congenital malformation. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - November 7, 2015 Category: Pediatrics Authors: Alberto Peña Source Type: research
Prenatal diagnosis of cloacal malformation
Persistent cloaca malformation is the most severe type of anorectal and urogenital malformation. Decisions concerning the surgical treatment for this condition are taken during the first hours of life and may determine the quality of life of these patients. Thus, prenatal diagnosis becomes important for a prompt and efficient management of the fetus and newborn, and accurate counseling of the parents regarding its consequences and the future of the baby.Careful evaluation by ultrasonography, and further in-depth analysis with MRI, allow prenatal detection of characteristic findings, which can lead to diagnose or at least s...
Source: Seminars in Pediatric Surgery - November 7, 2015 Category: Pediatrics Authors: Jose L. Peiro, Federico Scorletti, Lourenco Sbragia Source Type: research
Early urologic Considerations in Patients with persistent cloaca
Cloacal malformations have been reported to occur in 1 in 50,000 live female births and represent one of the most complex conditions amongst anorectal malformations. Multidisciplinary care amongst colorectal, urologic and gynecologic providers is critical to optimizing patient care and ultimately clinical outcomes. Urologic conditions occur with an increased frequency in cloaca patients compared to patients with other types of ARM. 1–3 The morbidity of the upper and lower urinary tract dysfunction/malformations at times can be severe; manifested by urinary tract infection, lower urinary tract symptoms, urinary incontinen...
Source: Seminars in Pediatric Surgery - November 7, 2015 Category: Pediatrics Authors: Brian A. VanderBrink, Pramod P. Reddy Source Type: research
Gynecologic concerns in patients with cloacal anomaly
Children with anorectal malformations (ARM) constitute a significant group within a pediatric surgery practice. It is important with female cases of anorectal malformations to consider the association of gynecologic anomalies, especially at the time of the definitive repair. However, it is critical to consider the association of such gynecologic anomalies when caring for patients with a cloacal anomaly. If not recognized, an opportunity to diagnose and treat such anomalies may be missed with the possibility of negative implications for future reproductive capacity. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - November 7, 2015 Category: Pediatrics Authors: Lesley Breech Source Type: research
Radiologic diagnosis of a newborn with cloaca
When a female is born and has only a single perineal orifice on the newborn clinical examination, a diagnosis of Cloaca type of anorectal malformation is made. Along with associated malformations which may initiate the ordering of radiologic imaging, there are a finite number of radiologic tests that are performed to help in the immediate management of the patient with cloaca. The following discussion will outline the most important radiologic tests and demonstrate examples of images from newborn females with cloaca. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - November 7, 2015 Category: Pediatrics Authors: Steven J. Krauss Source Type: research
Use of rotational fluoroscopy and 3-d reconstruction for pre-operative imaging of complex cloacal malformations
Complex cloacal malformations are associated with a wide spectrum of anatomic defects involving the gastrointestinal, urinary, and gynecologic tracts; the variety and complexity of these defects complicate surgical planning and repair. Rotational fluoroscopy with 3-D reconstruction provides precise anatomic detail, particularly regarding length of the common channel, appearance/location of the vagina(s) and bladder, which facilitates surgical planning and determination of prognosis. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - November 7, 2015 Category: Pediatrics Authors: Manish N. Patel Source Type: research
Long-term urological outcomes in cloacal anomalies
Cloacal anomalies are the most complex and severe form of congenital anorectal (ARM) and urogenital malformations, and it has been well documented that increased severity of ARM leads to worse outcomes. While short-term data on persistent cloaca are available, a paucity of data on long-term outcomes exists, largely due to a lack of uniform terminology, inclusion with other ARM and evolution of the operative technique. On comprehensive review of the published literature on long-term urological outcomes in patients with cloacal anomalies, we found a significant risk of chronic kidney disease and incontinence, however, with i...
Source: Seminars in Pediatric Surgery - November 7, 2015 Category: Pediatrics Authors: Brian T. Caldwell, Duncan T. Wilcox Source Type: research
