肛门直肠畸形的管理

The management of anorectal malformations.

作者信息

Wang N L, Chang P Y, Sheu J C, Yeh M L, Lin C J, Jong Y G, Chen C C

机构信息

Department of Pediatric Surgery, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.

出版信息

Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1992 Jan-Feb;33(1):29-34.

PMID:1626449

Abstract

From 1982 to 1990, 120 cases of anorectal malformation (84 males and 36 females) were admitted to Mackay Memorial Hospital; 101 cases were corrected surgically. Among these, 40 cases were high (H) or intermediate (I) type, and 61 cases were low (L) type. In the 40 cases of the H and I type, 13 (Group 1) received Stephens' procedure (SPR) and the remaining 27 (Group 2) received Peña's procedure (PSARP). For the L type, translocation anoplasty, cut-back anoplasty and limited PSARP were employed in 10, 45 and 6 cases, respectively. Anorectal continence results were evaluated by Kiesewetter's criteria. In Group 1, the results were good in 25%, fair in 17% and poor in 58%. In Group 2, the results were good in 70% and fair in 30%. In addition to better anorectal continence, the PSARP resulted in a lower rate of major complications. In the L type, the results were excellent without significant difference among the types of surgery employed.

摘要

1982年至1990年，台北马偕纪念医院收治了120例肛门直肠畸形患者（男性84例，女性36例）；其中101例行手术矫正。其中，高位（H）或中位（I）型40例，低位（L）型61例。在40例H型和I型病例中，13例（第1组）接受了斯蒂芬斯手术（SPR），其余27例（第2组）接受了佩尼亚手术（PSARP）。对于L型，分别有10例、45例和6例采用了经腹会阴肛门成形术、后切肛门成形术和有限的PSARP。采用基泽韦特标准评估肛门直肠节制结果。第1组中，结果良好的占25%，一般的占17%，差的占58%。第2组中，结果良好的占70%，一般的占30%。除了肛门直肠节制更好外，PSARP还导致主要并发症发生率较低。在L型中，手术效果极佳，所采用的手术类型之间无显著差异。