Chwals W J, Brennan L P, Weitzman J J, Woolley M M
Department of Surgery, Bowman Gray School of Medicine, Wake Forest Medical Center, Winston-Salem, NC.
J Pediatr Surg. 1990 Jul;25(7):715-8. doi: 10.1016/s0022-3468(05)80003-x.
This is a report of a simple transanal operation performed on six patients (age range, 19 months to 18 years), who underwent unsuccessful nonoperative management of complete rectal prolapse for at least 1 month (range, 1 month to 13 years). All patients had normal sweat chloride levels, normal chest radiographs, and normal barium enemas. None of the patients were neurologically compromised. At the time of surgery, all but one patient had occurrence of reducible prolapse with minor straining or with every bowel movement. No severe mucosal ulcerations were present. Surgical therapy consisted of the transanal mucosal sleeve resection described herein. In this series, there were no anastomotic leaks, no clinically evident strictures and no recurrence of prolapse in 1.5- to 19-year follow-up. Surgical therapy for rectal prolapse in infants and children is rarely necessary. Various complicated or ineffective operations for the treatment of this condition have been recommended in the past. This technique offers a simple, safe, and effective method of treating complete, medically intractable rectal prolapse in children.
本文报告了对6例患者（年龄范围为19个月至18岁）实施的一项简单经肛门手术，这些患者接受至少1个月（范围为1个月至13年）的完全直肠脱垂非手术治疗均未成功。所有患者汗液氯化物水平正常、胸部X线片正常、钡剂灌肠正常。所有患者均无神经功能障碍。手术时，除1例患者外，其他患者在轻度用力或每次排便时均出现可复性脱垂。无严重黏膜溃疡。手术治疗包括本文所述的经肛门黏膜套扎切除术。在本系列研究中，随访1.5至19年期间，无吻合口漏、无临床明显狭窄且无脱垂复发。婴幼儿直肠脱垂很少需要手术治疗。过去曾推荐过各种复杂或无效的手术来治疗这种疾病。该技术为治疗儿童完全性、药物治疗无效的直肠脱垂提供了一种简单、安全且有效的方法。
