{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T05:09:03Z","timestamp":1775538543537,"version":"3.50.1"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Aim of the study<\/jats:title>\n                    <jats:p>This study describes surgical approaches for different cases of cloaca tailored to anatomical diversity and severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted at Cairo University Specialized Pediatric Hospitals (2021\u20132024). Data included imaging findings [ultrasound, magnetic resonance image (MRI), distal loop gram, cloacogram, cystoscopy] and surgical techniques (single-stage or staged). Cases were categorized by vaginal depth and common channel length.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 20 patients, management was tailored to anatomy. For vaginal depth &amp;gt;2\u2005cm: 4 cases with long common channels (&amp;gt;3\u2005cm) had one-stage laparoscopic rectal and vaginal pull-through; 6 cases with short channels (&amp;lt;3\u2005cm) underwent posterior sagittal rectal pull-through 2 partial urogenital mobilization (PUM),4 total urogenital mobilization (TUM). For staged procedures: 3 cases with long channels and rectal endings below the coccyx underwent rectal pull-through followed by vaginal pull-through; 5 short-channel cases had laparoscopic rectal pull-through followed by TUM (2) or PUM (3). Vaginal depth &amp;lt;2\u2005cm required colon replacement in 2 cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Surgical management of cloacal malformations requires individualized approaches based on anatomical factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1780883","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T04:26:36Z","timestamp":1775535996000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Tailoring surgical approaches in different cloacal cases"],"prefix":"10.3389","volume":"13","author":[{"given":"Ahmed","family":"Arafa","sequence":"first","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Cairo University , Giza","place":["Egypt"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelhafeez Mohamed","family":"Abdelhafez","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Beni Suef University , Beni Suef","place":["Egypt"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar N.","family":"Abdelhakeem","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Minia University , Minia","place":["Egypt"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed M.","family":"Akoula","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Minia University , Minia","place":["Egypt"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed S.","family":"Ragab","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Portsaid University , Port Said","place":["Egypt"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed E.","family":"Arafat","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Cairo University , Giza","place":["Egypt"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"B1","first-page":"211","article-title":"Surgical management of cloacal malformations in pediatric patients","volume":"53","author":"Smith","year":"2018","journal-title":"J Pediatr Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2004","DOI":"10.1016\/j.jpedsurg.2019.04.005","article-title":"The cloacal anomalies: anatomical insights through a complex spectrum","volume":"54","author":"AbouZeid","year":"2019","journal-title":"J Pediatr Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1016\/j.jpedsurg.2003.11.033","article-title":"Surgical management of cloacal malformations: a review of 339 patients","volume":"39","author":"Pe\u00f1a","year":"2004","journal-title":"J Pediatr Surg"},{"key":"B4","first-page":"312","article-title":"Review of surgical outcomes for cloacal malformations: consensus and controversies","volume":"29","author":"Brown","year":"2020","journal-title":"Pediatric Surgery Journal"},{"key":"B5","first-page":"20","article-title":"Cloacal malformations: classification and management","volume":"16","author":"Levitt","year":"2007","journal-title":"Semin Pediatr Surg"},{"key":"B6","first-page":"3","article-title":"The management of anorectal malformations","volume":"32","author":"Pe\u00f1a","year":"2008","journal-title":"World J Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"240","DOI":"10.3389\/fped.2019.00240","article-title":"Cloacal malformations: technical aspects of the reconstruction and factors which predict surgical complexity","volume":"7","author":"Wood","year":"2019","journal-title":"Front Pediatr"},{"key":"B8","first-page":"1039","article-title":"Surgical management of cloacal malformations","volume":"48","author":"Wood","year":"2013","journal-title":"J Pediatr Surg"},{"key":"B9","first-page":"219","article-title":"Anorectal malformations: a unified theory of embryogenesis","volume":"14","author":"Levitt","year":"2005","journal-title":"Semin Pediatr Surg"},{"key":"B10","first-page":"45","article-title":"One-stage surgical approaches for cloacal malformations","volume":"37","author":"Patel","year":"2021","journal-title":"Pediatr Surg Int"},{"key":"B11","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.jpedsurg.2021.12.024","article-title":"Single-stage procedures for anorectal malformations: a systematic review and meta-analysis","volume":"57","author":"Hartford","year":"2022","journal-title":"J Pediatr Surg"},{"key":"B12","first-page":"56","article-title":"Colon replacement in cloacal malformations with insufficient vaginal depth","volume":"12","author":"Kumar","year":"2018","journal-title":"J Pediatr Surg Case Rep"},{"key":"B13","first-page":"614","article-title":"Early vaginal replacement in cloacal malformations: a single-center experience","volume":"13","author":"Shilpa","year":"2017","journal-title":"J Pediatr Urol"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1780883\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T04:26:38Z","timestamp":1775535998000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1780883\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":13,"alternative-id":["10.3389\/fsurg.2026.1780883"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1780883","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]},"article-number":"1780883"}}