Chew Simon S B, Rieger Nick A
Colorectal Unit, University Department of Surgery, The Queen Elizabeth Hospital, University of Adelaide, Adelaide, Australia.
Aust N Z J Obstet Gynaecol. 2004 Feb;44(1):68-71. doi: 10.1111/j.1479-828X.2004.00175.x.
To describe an operative technique for the repair of anovaginal fistulae secondary to obstetric injury and to assess its functional outcome and patient satisfaction.
An operative repair involving division of the anovaginal fistula, closure of rectal and vaginal walls, anterior levatoplasty and overlapping sphincteroplasty is described. Postoperative complications and recurrence were recorded. A telephone interview was carried out to assess the functional outcome and the satisfaction score.
Seven consecutive patients had a repair of an obstetric-related anovaginal fistula. Their mean age was 34 years (range: 22-72). They had a mean duration of symptoms of 14 months (range: 1.5-54). Four patients did not have any previous repair and no stoma was necessary in any of the seven patients. There was no significant postoperative complication and only one recurrence. Telephone interviews were conducted for six patients and one was lost to follow-up. The mean follow-up period was 24 months (11-35). The Wexner's continence score improved from a mean preoperative score of 13.4 to a mean postoperative score of 5.6. With satisfaction scores ranging from +3 to -3 (+3 indicating complete satisfaction and -3 indicating complete dissatisfaction), five patients scored 1 and one scored 0.
This technique is straightforward and effective in healing obstetric-related anovaginal fistula. It achieves improved continence and reasonable satisfaction.
描述一种修复产科损伤继发的肛门阴道瘘的手术技术，并评估其功能结果和患者满意度。
描述了一种手术修复方法，包括分离肛门阴道瘘、关闭直肠和阴道壁、前路提肛肌成形术和重叠括约肌成形术。记录术后并发症和复发情况。通过电话访谈评估功能结果和满意度评分。
连续7例患者接受了产科相关肛门阴道瘘的修复手术。她们的平均年龄为34岁（范围：22 - 72岁）。症状的平均持续时间为14个月（范围：1.5 - 54个月）。4例患者既往未进行过任何修复，7例患者均无需造口。术后无明显并发症，仅1例复发。对6例患者进行了电话访谈，1例失访。平均随访期为24个月（11 - 35个月）。韦克斯纳失禁评分从术前平均13.4分提高到术后平均5.6分。满意度评分范围为+3至 - 3（+3表示完全满意， - 3表示完全不满意），5例患者评分为1分，1例评分为0分。
该技术在治疗产科相关肛门阴道瘘方面简单有效。它能改善控便能力并获得合理的满意度。
