Conservative Management of Major Anastomotic Leaks Occurring after Primary Repair in Esophageal Atresia with Fistula: Role of Extrapleural Approach.

Aims: We are reporting single-institution's experience regarding the role of conservative management in 38 cases of minor and major anastomotic leaks [AL] occurring after primary surgery of esophageal atresia [EA] with tracheo-esophageal fistula [TEF] during last 17 years between 2000 and 2017. In this retrospective review, we are sharing our experience and protocol of management of AL with more emphasis to evaluate: (a) role of conservative treatment in major AL (b) role of extra-pleural approach in enhancing the success rate in conservative treatment in major AL (c) to define the criteria for major & minor leaks and (d) to evaluate the role of ventilation in primary EA surgery to control AL.

Methods: All these cases were operated through extra-pleural approach and out of total 203 cases, 38[18.

Anterior sagittal anorectoplasty for anovestibular fistula.

Anterior sagittal anorectoplasty (ASARP) was used for the definitive correction in 107 cases of anovestibular fistula (AVF) between 1996 and 2005. These cases were subjected to three different types of treatment regimes during the same period. Majority of the cases (78) were operated in one stage where postoperatively an early oral feed was started (A).

Complete bladder exstrophy with a normal phallus: A variant of superior vesical fissure.

Variations in the anatomic defects of the bladder exstrophy are well recognized, but their incidence is extremely low. Here the authors describe a rare case of superior vesical fissure in which a relatively large defect caused the whole bladder to prolapse outside. A review of literature found only 2 other cases that resembled our case.