Yamataka Atsuyuki, Kato Yoshifumi, Lee Kyeong Deok, Lane Geoffrey, Kusafuka Junichi, Okazaki Tadaharu
Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
J Laparoendosc Adv Surg Tech A. 2009 Apr;19 Suppl 1:S241-3. doi: 10.1089/lap.2008.0144.supp.
We report a surgical technique that we developed to facilitate complete excision of rectourethral fistula (RUF)in male patients with imperforate anus (IA). A 6-month-old boy with rectobulbar urethral fistula (bulbar-RUF)had laparoscopic repair of IA. During laparoscopic dissection of the RUF, a fine flexible endoscope was inserted into the rectum through an opening made in the anterior rectal wall. Endoscopy of the rectum allowed the level of laparoscopic dissection to be observed intraluminally, allowing the bulbar-RUF to be excised exactly at its distal end. He is well after follow-up of 9 months with no evidence of residual RUF on radiologic investigations.We have since used this technique to treat another IA patient with prostatic-RUF successfully.
我们报告了一种我们开发的手术技术，该技术有助于在患有肛门闭锁（IA）的男性患者中完全切除直肠尿道瘘（RUF）。一名患有直肠球部尿道瘘（球部-RUF）的6个月大男孩接受了IA的腹腔镜修复术。在腹腔镜下解剖RUF时，通过直肠前壁的开口将一根精细的柔性内窥镜插入直肠。直肠内镜检查可在管腔内观察腹腔镜解剖的水平，从而使球部-RUF能够在其远端精确切除。经过9个月的随访，他情况良好，影像学检查未发现残留RUF的迹象。此后，我们使用该技术成功治疗了另一例患有前列腺-RUF的IA患者。
