临床小儿外科杂志
臨床小兒外科雜誌
림상소인외과잡지
JOURNAL OF CLINICAL FEDIATRIC SURGERY
2014年
6期
546-547
,共2页
周薇莉%孙立宝%赵晓波%孙文丽
週薇莉%孫立寶%趙曉波%孫文麗
주미리%손립보%조효파%손문려
肛门闭锁%肛管%外科手术
肛門閉鎖%肛管%外科手術
항문폐쇄%항관%외과수술
Anus,Imperforate%Anal Canal%Surgical Procedures,Operative
目的探讨限制性后人字入路直肠肛门及外括约肌成形术治疗中低位肛门闭锁合并会阴瘘的临床应用价值。方法统计本院2010年2月至2013年6月收治的先天性肛门闭锁合并会阴瘘患儿47例,均采用限制性(3 cm 以内)切口,显露瘘管及直肠下端,在直肠下端的后方,将肛门外括约肌复合体部分切开,将两侧的肌纤维环包于直肠下端半周,完成外括约肌成形术。在中线后切瘘管及直肠壁2 cm,与正常肛隐窝处完成肛门成形术。结果本组47例肛门闭锁合并会阴瘘患儿经该术式获得良好的效果,术后全部病例均获随访,除2例因瘢痕体质出现肛门瘢痕性狭窄和1例因继发直肠扩张术后发生便秘外,全部患儿恢复自主排便,无便失禁及黏膜外翻等并发症,肛门外观良好。结论该术式操作简单,局部创伤小,术后避免了直肠回缩,并发症少,不需扩肛,随访疗效满意。
目的探討限製性後人字入路直腸肛門及外括約肌成形術治療中低位肛門閉鎖閤併會陰瘺的臨床應用價值。方法統計本院2010年2月至2013年6月收治的先天性肛門閉鎖閤併會陰瘺患兒47例,均採用限製性(3 cm 以內)切口,顯露瘺管及直腸下耑,在直腸下耑的後方,將肛門外括約肌複閤體部分切開,將兩側的肌纖維環包于直腸下耑半週,完成外括約肌成形術。在中線後切瘺管及直腸壁2 cm,與正常肛隱窩處完成肛門成形術。結果本組47例肛門閉鎖閤併會陰瘺患兒經該術式穫得良好的效果,術後全部病例均穫隨訪,除2例因瘢痕體質齣現肛門瘢痕性狹窄和1例因繼髮直腸擴張術後髮生便祕外,全部患兒恢複自主排便,無便失禁及黏膜外翻等併髮癥,肛門外觀良好。結論該術式操作簡單,跼部創傷小,術後避免瞭直腸迴縮,併髮癥少,不需擴肛,隨訪療效滿意。
목적탐토한제성후인자입로직장항문급외괄약기성형술치료중저위항문폐쇄합병회음루적림상응용개치。방법통계본원2010년2월지2013년6월수치적선천성항문폐쇄합병회음루환인47례,균채용한제성(3 cm 이내)절구,현로루관급직장하단,재직장하단적후방,장항문외괄약기복합체부분절개,장량측적기섬유배포우직장하단반주,완성외괄약기성형술。재중선후절루관급직장벽2 cm,여정상항은와처완성항문성형술。결과본조47례항문폐쇄합병회음루환인경해술식획득량호적효과,술후전부병례균획수방,제2례인반흔체질출현항문반흔성협착화1례인계발직장확장술후발생편비외,전부환인회복자주배편,무편실금급점막외번등병발증,항문외관량호。결론해술식조작간단,국부창상소,술후피면료직장회축,병발증소,불수확항,수방료효만의。
Objetive To explore the clinic value of anoplasty and external anal sphincteroplasty via pos-terior approach with Y-shaped incision to repair intermediate and low anorectal malformation complicated with rectal perineal fistula.Methods 47 patients admitioned from February 2010 to June 2013 with intermediate and low anorectal malformation complicated with rectal perineal fistula were enrolled in this study.Via the pos-terior approach with Y-shaped incision(<3 cm )was made to expose the rectum and fistula.The external anal sphincteroplasty was performed by overlapping the ends of the muscle around the low rectum.The rectal perine-al fistula was resected 2 cm and anoplasty was performed.Results All surgeries were successfully performed. Voluntary bowel movement and fecal continence was restored on 47 patients after surgery.2 cases had anal scar straitness because of scarred physique and 1 case had secondary constipation because of rectum dilatation. Conclusion The surgeried method is less complicated and invasive to repair intermediate and low anorectal malformation complicated with rectal perineal fistula.By using this procedure,better sphincter shape and fecal function is achieved on patients.