• Inbal Samuk, Eva E Amerstorfer, Maria Fanjul, Barbara D Iacobelli, Gabriele Lisi, Paola Midrio, Anna Morandi, Eberhard Schmiedeke, Pernilla Stenstrom, and Christien Sleeboom.
• Department of Pediatric Surgery, Schneider Children's Medical Center of Israel, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: Inbal.samuk@gmail.com.
• J. Pediatr. 2020 Jul 1; 222: 207-212.

ObjectiveTo review the Anorectal Malformation Network experience with perineal groove (PG) focusing on its clinical characteristics and management.Study DesignData on patients with PG managed at 10 participating Anorectal Malformation Network centers in 1999-2019 were collected retrospectively by questionnaire.ResultsThe cohort included 66 patients (65 females) of median age 1.4 months at diagnosis. The leading referral diagnosis was anal fissure (n = 20 [30.3%]): 23 patients (34.8%) had anorectal malformations. Expectant management was practiced in 47 patients (71.2%). Eight (17%) were eventually operated for local complications. The median time to surgery was 14 months (range, 3.0-48.6 months), and the median age at surgery was 18.3 months (range, 4.8-58.0 months). In the 35 patients available for follow-up of the remaining 39 managed expectantly, 23 (65.7%) showed complete or near-complete self-epithelization by a mean age 15.3 months (range, 1-72 months) and 4 (11.4%) showed partial self-epithelization by a mean age 21 months (range, 3-48 months). Eight patients showed no resolution (5 were followed for ≤3 months). Nineteen patients (28.7%) were primarily treated with surgery. In total, 27 patients were operated. Dehiscence occurred in 3 of 27 operated patients (11.1%).ConclusionsPG seems to be an underestimated anomaly, frequently associated with anorectal malformations. Most cases heal spontaneously; therefore, expectant management is recommended. When associated with anorectal malformations requiring reconstruction, PG should be excised in conjunction with the anorectoplasty.Copyright © 2020 Elsevier Inc. All rights reserved.

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