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[痔切除术后肛门狭窄采用肛管推进皮瓣肛门成形术。1例临床病例报告]

[Anoplasty with House advancement flap for anal stenosis after hemorrhoidectomy. Report of a clinical case].

作者信息

Ettorre G M, Paganelli L, Alessandroni L, Baiano G, Tersigni R

机构信息

Unità Operativa di Chirurgia Generale 1 Flajani Dipartimento di Scienze Chirurgiche Azienda Ospedaliera San Camillo-Forlanini, Roma.

出版信息

Chir Ital. 2001 Jul-Aug;53(4):571-4.

Abstract

Anorectal strictures may occur after anorectal surgery and in particular after surgical haemorrhoidectomy. Anal examination under general anaesthesia was recommended to evaluate the stricture and to choose the appropriate technique. The house advancement flap has been recently proposed for postsurgical anal stenosis repair. The house flap receives its blood supply through unnamed vessels extending through a fatty pedicle from the underlying external sphincter muscle and not from a skin or mucosal bridge like the other common flaps (Y-V and mucosal advancement flap). The aims of this study were firstly to report a case of post-haemorrhoidectomy anal stenosis in a 68-year-old man treated in our institution by house advancement anoplasty and secondly to evaluate the efficacy and safety of this new technique. The technique was totally successful in alleviating anal stenosis and maintaining faecal continence. House advancement anoplasty should be part of the armamentarium of colon and rectal surgeons for treating severe anal stenosis.

摘要

肛肠狭窄可能发生在肛肠手术后,尤其是手术治疗痔切除术后。建议在全身麻醉下进行肛门检查,以评估狭窄情况并选择合适的技术。最近有人提出采用改良推进皮瓣修复术后肛门狭窄。改良推进皮瓣通过无名血管获得血供,这些血管从下方的外括约肌经脂肪蒂延伸而来,而非像其他常见皮瓣(Y-V皮瓣和黏膜推进皮瓣)那样通过皮肤或黏膜桥供血。本研究的目的,一是报告我院采用改良推进肛门成形术治疗的1例68岁男性痔切除术后肛门狭窄病例,二是评估这项新技术的有效性和安全性。该技术在缓解肛门狭窄和维持大便失禁方面完全成功。改良推进肛门成形术应成为结直肠外科医生治疗严重肛门狭窄的手段之一。

引用本文的文献

1
Surgical treatment of anal stenosis.
World J Gastroenterol. 2009 Apr 28;15(16):1921-8. doi: 10.3748/wjg.15.1921.

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