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一种用于产科肛门括约肌损伤二期修复的外科技术；括约肌-阴道-会阴成形术。

A surgical technique for secondary repair of obstetric anal sphincter injuries; sphinctero-vagino-perineoplasty.

作者信息

Şimsek Arife, Ateş Mustafa, Dirican Abuzer, Özgör Dinçer

机构信息

İnönü University Faculty of Medicine, Department of General Surgery, Malatya, Turkey.

出版信息

Turk J Obstet Gynecol. 2018 Dec;15(4):249-253. doi: 10.4274/tjod.12369. Epub 2019 Jan 9.

DOI:10.4274/tjod.12369
PMID:30693141
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6334249/
Abstract

OBJECTIVE

This study was conducted to present the preliminary results of seven patients treated with sphinctero-vagino-perineoplasty for secondary repair of obstetric anal sphincter injuries.

MATERIALS AND METHODS

This retrospective study was conducted on the records of seven patients who underwent secondary repair of obstetric anal sphincter injuries at the colorectal surgery unit of a tertiary care center between February 2015 and December 2017.

RESULTS

All patients with solid stool incontinence were fully recovered at postoperative month 3. The Wexner incontinence score was significantly improved (decreased from 14.12 [range: 8-20] to 2.28 [range: 1-4]). The complication rate was 85.7% (wound infection, abscess, hematoma, detachment).

CONCLUSION

Combined repair of anal sphinchters, perineal body, superficial transverse perineal muscles, and bulbospongious muscles, which contribute to anal continence, may improve surgical outcomes in patients with obstetric anal sphincter injuries.

摘要

目的

本研究旨在呈现7例接受括约肌-阴道-会阴成形术治疗产科肛门括约肌损伤二期修复患者的初步结果。

材料与方法

本回顾性研究对2015年2月至2017年12月期间在一家三级医疗中心的结直肠外科接受产科肛门括约肌损伤二期修复的7例患者的记录进行分析。

结果

所有存在固体粪便失禁的患者在术后3个月时均完全恢复。韦克斯纳失禁评分显著改善（从14.12[范围：8 - 20]降至2.28[范围：1 - 4]）。并发症发生率为85.7%（伤口感染、脓肿、血肿、分离）。

结论

对有助于肛门节制的肛门括约肌、会阴体、会阴浅横肌和球海绵体肌进行联合修复，可能改善产科肛门括约肌损伤患者的手术效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0520/6334249/bfc79003c896/TJOG-15-249-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0520/6334249/8e30bab1d19d/TJOG-15-249-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0520/6334249/fb47e71e05c7/TJOG-15-249-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0520/6334249/e4fa0a23c122/TJOG-15-249-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0520/6334249/bfc79003c896/TJOG-15-249-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0520/6334249/8e30bab1d19d/TJOG-15-249-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0520/6334249/fb47e71e05c7/TJOG-15-249-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0520/6334249/e4fa0a23c122/TJOG-15-249-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0520/6334249/bfc79003c896/TJOG-15-249-g4.jpg

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World J Gastroenterol. 2017 Jan 7;23(1):11-24. doi: 10.3748/wjg.v23.i1.11.
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Short- and long-term results of secondary anterior sphincteroplasty in 33 patients with obstetric injury.33 例产科损伤患者行二期肛门括约肌修补术的近期和远期疗效。
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Dis Colon Rectum. 2009 Jun;52(6):1089-94. doi: 10.1007/DCR.0b013e3181a0a79c.
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[How I do... the management of fourth degree perineal injury following vaginal delivery?].[我如何进行……阴道分娩后四度会阴裂伤的处理？]
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Obstetric anal sphincter injury: incidence, risk factors, and management.产科肛门括约肌损伤：发生率、危险因素及处理
Ann Surg. 2008 Feb;247(2):224-37. doi: 10.1097/SLA.0b013e318142cdf4.
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[Surgical treatment of fecal incontinence secondary to obstetric trauma].[产科创伤继发大便失禁的外科治疗]
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Short-term and long-term effects of obstetric anal sphincter injury and their management.产科肛门括约肌损伤的短期和长期影响及其处理
Curr Opin Obstet Gynecol. 2005 Dec;17(6):605-10. doi: 10.1097/01.gco.0000191901.69320.a0.
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