Managing prenatally diagnosed asymptomatic congenital cystic adenomatoid malformation.

Aim: To review our cases of congenital cystic adenomatoid malformation (CCAM) with special emphasis on the management of prenatally diagnosed asymptomatic CCAM (PDA-CCAM).

Methods: A total of 42 consecutive CCAM patients treated between 1990 and 2008 at our institution and affiliated hospitals were divided into four groups, according to whether prenatal diagnosis was made [PD (+) or (-)], whether patients were symptomatic [S (+) or (-)], whether there was any increase in size observed radiologically [R (+) or (-)], and whether surgical resection was performed [X (+) or (-)], to give a symptomatic early surgery group diagnosed prenatally (group A; n = 15): PD (+), S (+), R (+), X (+); an asymptomatic early surgery group diagnosed prenatally (group B; n = 8): PD (+), S (-), R (-), X (+); a conservative observation group diagnosed prenatally (group C; n = 6): PD (+), S (-), R (-), X (-); and a symptomatic surgery group diagnosed postnatally (group D; n = 13): PD (-), S (+), R (unknown), X (+). Patient demographics, effects of surgical stress, histopathology, and outcome were compared between the four groups.

Laparoscopically assisted anorectovaginoplasty for selected types of female anorectal malformations.

Purpose: The aim of this study was to describe laparoscopically assisted anorectovaginoplasty (LAARVP) for the repair of selected types of female anorectal malformation.

Methods: Five cases (case 1, rectovaginal fistula with a high rectum; case 2, rectovestibular fistula with double vagina; case 3, rectovestibular fistula with absent vagina; case 4, anovestibular fistula with absent vagina; case 5, cloaca) were reviewed.

Results: Patient 4 had undergone a posterior sagittal anorectoplasty without vaginoplasty at another hospital after misdiagnosis of simple anovestibular fistula.