Bibliographic Details
| Title: |
HIV-associated rectovaginal fistulae in children: a single-centre retrospective study in the antiretroviral era. |
| Authors: |
Alberti, Piero1 (AUTHOR), Westgarth-Taylor, Christopher1 (AUTHOR), Trovalusci, Emanuele1,2 (AUTHOR), Charlton, Robyn3 (AUTHOR), Brisighelli, Giulia1 (AUTHOR) giuliabrisighelli@gmail.com |
| Source: |
Pediatric Surgery International. 7/8/2024, Vol. 40 Issue 1, p1-10. 10p. |
| Subject Terms: |
*COLOSTOMY, *CHILD patients, *HIV infection complications, *PANCREATIC fistula, *FISTULA |
| Abstract: |
Purpose: Acquired rectovaginal fistulae (RVF) are a complication of paediatric HIV infection. We report our experience with the surgical management of this condition. Methods: We retrospectively reviewed the records of paediatric patients with HIV-associated RVF managed at Chris Hani Baragwanath Academic Hospital (2011–2023). Information about HIV management, surgical history, and long-term outcomes was collected. Results: Ten patients with HIV-associated RVF were identified. Median age of presentation was 2 years (IQR: 1–3 years). Nine patients (9/10) underwent diverting colostomy, while one demised before the stoma was fashioned. Fistula repair was performed a median of 17 months (IQR: 7.5–55 months) after colostomy. An ischiorectal fat pad was interposed in 5/9 patients. Four (4/9) patients had fistula recurrence, 2/9 patients developed anal stenosis, and 3/9 perineal sepsis. Stoma reversal was performed a median of 16 months (IQR: 3–25 months) after repair. Seven patients (7/9) have good outcomes without soiling, while 2/9 have long-term stomas. Failure to maintain viral suppression after repair was significantly associated with fistula recurrence and complications (φ = 0.8, p < 0.05). Conclusion: While HIV-associated RVFs remain a challenging condition, successful surgical treatment is possible. Viral suppression is a necessary condition for good outcomes. [ABSTRACT FROM AUTHOR] |
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