Williams N S, Hallan R I, Koeze T H, Watkins E S
Surgical Unit, London Hospital Medical College, UK.
Br J Surg. 1989 Nov;76(11):1191-4. doi: 10.1002/bjs.1800761124.
A new operation is described in which a neorectum and neoanal sphincter mechanism have been constructed to restore gastrointestinal continuity and continence in a patient who had previously undergone proctocolectomy and a permanent ileostomy. The neorectum was constructed by forming a triplicated pouch from the distal ileum. The neoanal sphincter was fashioned from a transposed gracilis muscle and was activated electrically by an implanted stimulator. A period of chronic low frequency stimulation altered the muscle characteristics and enabled the neosphincter to contract continually without fatigue. Complete continence was achieved by the neosphincter gripping a Silastic plug inserted within the efferent spout of the pouch. The patient was able to void completely when the stimulator was switched off and the plug removed.
本文描述了一种新手术，该手术为一名先前接受过直肠结肠切除术和永久性回肠造口术的患者构建了新直肠和新肛门括约肌机制，以恢复胃肠道连续性和控便能力。新直肠由回肠末端形成的三层袋构建而成。新肛门括约肌由转位的股薄肌制成，并由植入的刺激器进行电激活。一段时间的慢性低频刺激改变了肌肉特性，使新括约肌能够持续收缩而不疲劳。新括约肌通过夹住插入袋传出口内的硅橡胶塞实现完全控便。当刺激器关闭且塞子取出时，患者能够完全排尿。
