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[腹腔镜手术治疗肛门直肠畸形]

[Laparoscopic surgical treatment of anorectal malformations].

作者信息

Lima M, Antonellini C, Ruggeri G, Libri M, Gargano T, Mondardini M C

机构信息

Chirurgia Pediatric, Scuola di Specializzazione in Chirurgia Pediatrica, Bologna.

出版信息

Pediatr Med Chir. 2006;28(4-6):79-82.

Abstract

Anorectal Malformations (ARM) include a wide spectrum of anomalies, ranging from anal and rectal agenesis (usually associated with a recto-urethral, rectovaginal or recto-vestibular fistula) to ano-cutaneous fistula. On the basis of studies on the anatomy of the muscular structures contained in the pelvic cavity and on the physiology of the mechanisms which regulate the continence, many different techniques have been performed to allow a surgical treatment for the ARMs and to obtain post-operative results as nearer as possible to normality, that is to an adequate colic motility and a defecation control. In 2000, a new surgical technique for high and intermediate ARMs has been introduced, the laparoscopically assisted ano-rectal pull-through (LAARP) according to Georgeson. At the Department of Pediatric Surgery, Bologna University, from 2000 to nowadays, we have treated with LAARP 7 cases of high ARMs, all male patients and with colostomy. The average age at operation was between 2 and 10 months.

摘要

肛门直肠畸形(ARM)包括一系列广泛的异常情况,从肛门和直肠闭锁(通常伴有直肠尿道、直肠阴道或直肠前庭瘘)到肛门皮肤瘘。基于对盆腔内肌肉结构解剖学以及调节控便机制生理学的研究,人们实施了许多不同的技术来对肛门直肠畸形进行手术治疗,并尽可能使术后结果接近正常状态,即实现适当的结肠蠕动和排便控制。2000年,一种针对高位和中位肛门直肠畸形的新手术技术被引入,即乔治森描述的腹腔镜辅助肛门直肠拖出术(LAARP)。在博洛尼亚大学儿外科,从2000年至今,我们用LAARP治疗了7例高位肛门直肠畸形患者,均为男性且都有结肠造口术。手术时的平均年龄在2至10个月之间。

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