直肠前庭瘘破裂缺损是婴儿后天性直肠前庭瘘治疗不当所致。
Recto-vestibular disruption defect resulted from the malpractice in the treatment of the acquired recto-vestibular fistula in infants.
作者信息
Zhang Ting-Chong, Pang Wen-Bo, Chen Ya-Jun, Zhang Jin-Zhe
机构信息
Department of Surgery, Beijing Children's Hospital affiliated to Capital Medical University, Beijing 100045, China.
出版信息
World J Gastroenterol. 2007 Apr 7;13(13):1980-2. doi: 10.3748/wjg.v13.i13.1980.
AIM
To explore the pathogenesis of the rectovestibular disruption (RVD) defect and to recommend a successful repair, and prevention of it.
METHODS
Clinical records of 15 girls, age ranged from 3 to 15 (median, 7.5) years, with acquired rectovestibular fistula (RVF) mistreated before were retrospectively reviewed. All of them presented an abnormal appearance of perineum and were suffering from some degree of fecal incontinence, and those were graded III to IV by Li Zheng's Score. Repair of anal sphincters and reconstruction of perineum body and skin by anterior perineal rectoanoplasty were performed in all cases.
RESULTS
Operation in all cases was successful. The perineum looked practically normal and fecal continence score rose up to VI by Li Zheng's Score.
CONCLUSION
The conventional treatment for anal fistula, lay-open or string-treatment, should be considered as malpractice of RVF, and certainly leads to the RVD defect, and the anterior perineal rectoanoplasty could cure it satisfactorily.
目的
探讨直肠前庭瘘（RVD）缺损的发病机制，推荐一种成功的修复方法并预防其发生。
方法
回顾性分析15例年龄在3至15岁（中位数7.5岁）、曾接受过不当治疗的后天性直肠前庭瘘（RVF）女孩的临床记录。所有患者均有会阴外观异常，并存在一定程度的大便失禁，根据李正评分法分级为Ⅲ至Ⅳ级。所有病例均采用经会阴直肠肛门成形术修复肛门括约肌，重建会阴体和皮肤。
结果
所有病例手术均成功。会阴外观基本正常，大便失禁评分根据李正评分法升至Ⅵ级。
结论
肛瘘的传统治疗方法，如切开或挂线治疗，应被视为直肠前庭瘘的不当治疗，必然会导致直肠前庭瘘缺损，而经会阴直肠肛门成形术可以令人满意地治愈该病。
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