经肛门后矢状入路直肠肛门成形术治疗直肠肛门畸形患者的侧方直肠位置不良。
Redo posterior sagittal anorectoplasty for lateral mislocation in patients with anorectal malformations.
机构信息
Department of Pediatric Colorectal and Pelvic Reconstruction Surgery, Nationwide Children's Hospital, Columbus, OH.
Department of Pediatric Colorectal and Pelvic Reconstruction Surgery, Nationwide Children's Hospital, Columbus, OH.
出版信息
J Pediatr Surg. 2020 Nov;55(11):2521-2526. doi: 10.1016/j.jpedsurg.2020.05.029. Epub 2020 Jun 1.
BACKGROUND
Children undergoing repair of an anorectal malformation (ARM) may have persistent soiling and/or constipation postoperatively. An anatomic reason should be sought; one of the causes for these problems that may require reoperation is mislocation of the rectum and anus outside of the muscle complex.
METHODS
We reviewed our population of children who underwent re-do anorectoplasty surgery between 2014 and 2019. Indications for surgery and outcomes were recorded.
RESULTS
Twelve patients had a lateral mislocation and underwent reoperation. There were no immediate complications in this subgroup. 9 of 10 patients are clean, and 4 are now able to have voluntary bowel movements.
CONCLUSION
For patients who are found to have a significant lateral mislocation, we describe a new surgical technique that replaces the rectum and neo-anus directly in the midline through the muscle complex which may improve functional outcome.
背景
接受肛门直肠畸形（ARM）修复的儿童术后可能会持续弄脏内裤和/或便秘。应寻找解剖学原因；这些问题可能需要再次手术的原因之一是直肠和肛门在肌肉复合体外错位。
方法
我们回顾了 2014 年至 2019 年间接受再修复肛门直肠成形术的患儿人群。记录了手术指征和结果。
结果
12 例患者存在外侧错位并接受了再次手术。该亚组无即时并发症。10 例中的 9 例患者干净，4 例现在能够自主排便。
结论
对于发现存在明显外侧错位的患者，我们描述了一种新的手术技术，通过肌肉复合体直接将直肠和新肛门置于中线，这可能改善功能结果。
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