CAJ | 학술논문

目的：探讨经肛门括约肌径路行直肠阴道瘘修补术的可行性和安全性。方法回顾分析北京协和医院基本外科1994年4月至2014年5月采用经肛门括约径肌径路手术治疗23例直肠阴道瘘患者的临床资料。结果23例患者均成功完成经肛门括约肌径路的直肠阴道瘘修补术；术后发生伤口感染3例（13％），均经换药后伤口愈合。术后随访3月至7年，经再次住院检查被确诊瘘口愈合者19例（82.6%），瘘口未完全愈合者4例（17.4%）。全组未发生直肠皮肤瘘和肛门功能障碍。结论经肛门括约肌径路行直肠阴道瘘修补术是一种安全可行且成功率较高的手术。
목적：탐토경항문괄약기경로행직장음도루수보술적가행성화안전성。방법회고분석북경협화의원기본외과1994년4월지2014년5월채용경항문괄약경기경로수술치료23례직장음도루환자적림상자료。결과23례환자균성공완성경항문괄약기경로적직장음도루수보술；술후발생상구감염3례（13％），균경환약후상구유합。술후수방3월지7년，경재차주원검사피학진루구유합자19례（82.6%），루구미완전유합자4례（17.4%）。전조미발생직장피부루화항문공능장애。결론경항문괄약기경로행직장음도루수보술시일충안전가행차성공솔교고적수술。
Objective To investigate the safety and feasibility of the posterior transsphincteric approach for rectovaginal fistulas repair. Method Data of 23 cases of rectovaginal fistulas treated by the transsphincteric approach in the Peking Union Medical College Hospital , from April 1994 to May 2014 were reviewed. The success rate of this surgical procedure and the postoperative complications were analyzed. Results The procedure of the transsphincteric approach for the repair of rectovaginal fistulas was performed successfully in all 23 cases. Three patients(13%) suffered surgical wound infection, which healed after regular dressing changes. In 19 cases, the fistulas were successfully repaired with an initial healing rate of 82.6%. The surgical repair failed to accomplish initial healing in 3 cases(13%). No complications including rectocutaneous fistula or anal sphincter malfunction occurred in these patients. Conclusion The transsphincteric approach for the repair of rectovaginal fistulas is a safe and feasible procedure with a good success rate.