Arnaud A, Sarles J C, Sielezneff I, Orsoni P, Joly A
Department of Digestive Surgery, Hopital Sainte-Marguerite, Université d'Aix Marseille II, France.
Dis Colon Rectum. 1991 Sep;34(9):744-7. doi: 10.1007/BF02051062.
Forty patients who had sphincter repair by one surgeon over the last 15 years were reviewed. The etiology of sphincter trauma was previous surgery (22), childbirth (14), and accidental trauma (4). Eleven patients had undergone at least one previous attempt at repair. Prior to operation, 12 patients were incontinent for liquid stool and 28 for formed stool. A technique of sphincter repair without overlapping was used. An associated diverting colostomy was carried out on seven patients who had had a previous failed repair. Follow-up was an average of 17 months after operation (range, 2-96 months). After operation, 25 patients were completely continent, 6 had occasional leaks of liquid stool, 4 were continent for solid stool only, and 5 showed no improvement. Neither diverting colostomy nor overlapping sutures appear to be mandatory for a successful repair of the anal sphincter after trauma.
回顾了过去15年中由一位外科医生进行括约肌修复的40例患者。括约肌损伤的病因包括既往手术（22例）、分娩（14例）和意外创伤（4例）。11例患者此前至少接受过一次修复尝试。术前，12例患者存在稀便失禁，28例患者存在成形便失禁。采用了一种无重叠的括约肌修复技术。7例既往修复失败的患者进行了相关的转流性结肠造口术。术后平均随访17个月（范围2 - 96个月）。术后，25例患者完全控便，6例偶尔有稀便渗漏，4例仅对固体大便能控便，5例无改善。对于创伤后肛门括约肌的成功修复，转流性结肠造口术和重叠缝合似乎都不是必需的。
