Rectal vestibular fistula I. What is rectal vestibular fistula? There are two types of rectal vestibular fistula, one is congenital anal atresia combined with rectal vestibular fistula, not in the scope of this section, this section describes the anal appearance of normal rectal vestibular fistula, is a common perianal disease in female children, the performance of the anus is normal in appearance, the formation of a fistula between the rectum and the vestibule of the vagina, the majority of fistulas in the diameter of the fistula in the 0.5cm, when the discharge of loose stools, there is feces from the fistula, perineal flushing; feces dry and hard, no special clinical signs, but also after individual children with a diameter of the fistula, the fistula in the vaginal area of the rectum and vaginal vestibule. Second, what is the cause of rectal vestibular fistula? The etiology of rectal vestibular fistula is still unknown, and geographic region has a certain relationship, in Asia, while the incidence of Western countries is very low, the main etiology of the doctrine: ①, immunocompromised doctrine; ②, congenital defects doctrine; ③, acquired infection academics. Third, how to treat rectal vestibular fistula? Once the rectal vestibular fistula is formed, it is difficult to heal, all need surgical treatment, according to the child’s age, the location of the fistula, the diameter of the fistula, local inflammation, choose the appropriate surgical method. Commonly used surgical methods are: ① fistula excision layered suture, the fistula excision and layered suture can be vaginal or rectal repair Advantages of the operation is simple, easy to remove the fistula. The disadvantage is that the recurrence rate is high; ②, the rectum whole layer or mucosal covering method. Advantage is that the operation is simple, low recurrence rate; disadvantage is that it is not applicable to cases with large diameter fistula, and there is a fistula left in the vaginal vestibule; ③, rectum muscle sheath detachment method. Advantages are low recurrence rate, can treat fistula diameter, fistula higher cases, the disadvantage is that the operation is complex, bleeding, postoperative defecation function has a certain impact; ④, “H” shape perineum body molding. Advantage is low recurrence rate, in situ anatomical alignment; disadvantage is the risk of perineal infection cracking, the operator’s surgical techniques and experience requirements. What are the common treatment methods in our hospital? Our common treatment method is summarized in the above method based on the use of improved fistula closure, perineal reconstruction, rectal mucosa rotating cover method, with small surgical trauma, simple operation, low recurrence rate, good appearance, easy to take care of, suitable for all types of rectal vestibular fistulae, the advantages of recurrence rate of less than 10%. What is the best age for surgery? The best age for surgery is after 6 months of age.