Department of Surgery, Upstate Medical University, Syracuse, NY, United States.
Department of Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands.
Semin Pediatr Surg. 2020 Dec;29(6):150998. doi: 10.1016/j.sempedsurg.2020.150998. Epub 2020 Nov 20.
Constipation and fecal incontinence are common problems in children after repair of an anorectal malformation (ARM). While many children can be effectively managed with an oral laxative regimen, others require a mechanical colonic washout to achieve social continence. Appendicostomy and cecostomy are two techniques which permit antegrade access to the colon for the purpose of enema delivery, which improves compliance and quality of life for patients and families. The purpose of this article is to review, using a case-based approach, the indications for placement of a channel for antegrade enema access, clinical scenarios in which one technique would be preferred over another, common complications following each procedure.
便秘和粪便失禁是肛门直肠畸形（ARM）修复后儿童常见的问题。虽然许多儿童可以通过口服泻药方案有效地进行管理，但其他儿童则需要机械结肠灌洗来实现社交节制。阑尾造口术和乙状结肠造口术是两种技术，它们允许经前向进入结肠进行灌肠，从而提高了患者和家属的依从性和生活质量。本文的目的是通过案例分析的方法，回顾经前向灌肠通道放置的适应证，一种技术优于另一种技术的临床情况，以及每种操作后的常见并发症。
