Department of Surgery, Children's Hospital, Fudan University, Shanghai 201102, People's Republic of China.
J Pediatr Surg. 2009 Dec;44(12):2359-63. doi: 10.1016/j.jpedsurg.2009.07.065.
The objective of this study is to introduce a modified Soave procedure for the treatment of vascular malformations involving the anorectum and sigmoid colon (VMARS) in children.
Cases of 12 children with VMARS between 2000 and 2008 were reviewed and analyzed. The confirmed diagnosis was established by barium enema, colonoscopy, computed tomography, and magnetic resonance imaging. All the patients underwent a modified Soave procedure. In 11 patients, Sarasola-Klose hemorrhoidectomy was used for the distal part of endorectal dissection.
The mean length of resected bowel was 22.5 cm, ranging from 17 to 28 cm. Histologically, the surgical specimens showed that the lesions were venous malformation. Postoperative recovery was uneventful. The patients had good continence with no rectal bleeding, but intermittent fecal soiling was noted in one case.
VMARS forms a unique subset of patients with vascular malformations who have rectal bleeding. The combination of Soave procedure and Sarasola-Klose hemorrhoidectomy is a safe and effective procedure for VMARS.
本研究旨在介绍一种改良的 Soave 手术方法,用于治疗涉及肛门直肠和乙状结肠的血管畸形(VMARS)的儿童病例。
回顾性分析 2000 年至 2008 年间收治的 12 例 VMARS 患儿的临床资料。通过钡剂灌肠、结肠镜检查、计算机断层扫描和磁共振成像等检查方法明确诊断。所有患儿均采用改良的 Soave 手术治疗。其中 11 例患儿在直肠内切除的远端采用 Sarasola-Klose 痔切除术。
平均切除肠段长度为 22.5cm,范围为 17~28cm。组织病理学检查显示病变为静脉畸形。术后恢复顺利,所有患儿均有良好的控便能力,无直肠出血,但 1 例患儿出现间歇性粪便污染。
VMARS 是一组具有直肠出血表现的独特血管畸形患者。Soave 手术联合 Sarasola-Klose 痔切除术是治疗 VMARS 的一种安全有效的方法。