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儿童各种顺行灌肠术并发症的预防与处理:文献综述

Prevention and management of complications in various antegrade enema procedures in children: a review of the literature.

作者信息

Soyer Tutku

机构信息

Department of Paediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

出版信息

Pediatr Surg Int. 2020 Jun;36(6):657-668. doi: 10.1007/s00383-020-04635-x. Epub 2020 Mar 17.

Abstract

The antegrade continence enema (ACE) procedures are successful surgical options to achieve bowel cleaning in children with faecal incontinence due to a neuropathy or an anorectal malformation and an intractable constipation. The reversed and orthotopic appendicocecostomy, tubularized ileal conduit and the tubularized cecal flap are frequently applied procedures in the treatment of faecal incontinence (FI). The most common complications are the stoma stenosis, leakage, prolapse, adhesive obstruction and the difficulty in catheterization. Each procedure has its own advantages and disadvantages with different complication rates. The postoperative complications of ACE procedures may reduce patient compliance and quality of life. Most of these complications can be preventable and are easy to manage. This review aimed to discuss the prevention and management strategies for various ACE procedure complications.

摘要

顺行性可控灌肠(ACE)手术是一种成功的手术选择,适用于因神经病变、肛门直肠畸形或顽固性便秘导致大便失禁的儿童,以实现肠道清洁。逆行和顺位阑尾盲肠造口术、管状回肠导管和管状盲肠瓣是治疗大便失禁(FI)时常用的手术方法。最常见的并发症是造口狭窄、渗漏、脱垂、粘连性肠梗阻和插管困难。每种手术方法都有其自身的优缺点和不同的并发症发生率。ACE手术的术后并发症可能会降低患者的依从性和生活质量。这些并发症大多是可以预防的,且易于处理。本综述旨在探讨各种ACE手术并发症的预防和管理策略。

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