Miller R, Bartolo D C, Locke-Edmunds J C, Mortensen N J
Department of Surgery, Bristol Royal Infirmary, UK.
Br J Surg. 1988 Feb;75(2):101-5. doi: 10.1002/bjs.1800750204.
To assess the functional results of treatment of faecal incontinence we carried out physiological and radiological measurements in 46 patients and 20 controls. Twenty patients were selected for conservative treatment and 26 for surgery (including 17 postanal repairs and 6 anterior sphincter repairs). The degree of incontinence was scored before and after treatment and postoperative investigations carried out on 17 patients (11 postanal repairs). Forty per cent of the conservative treatment group had a successful result compared with sixty-five per cent of the operative group as a whole and fifty-nine per cent of the postanal repair patients. Resting and 'squeeze' anal canal pressures were improved following postanal repair as was upper anal canal sensation but there was no change in the anorectal angle. We conclude that the anorectal angle is not crucial in maintaining continence.
为评估大便失禁的治疗效果，我们对46例患者和20例对照者进行了生理和放射学测量。20例患者选择保守治疗，26例接受手术治疗（包括17例肛门后修复术和6例肛门括约肌前部修复术）。在治疗前后对失禁程度进行评分，并对17例患者（11例行肛门后修复术）进行术后检查。保守治疗组40%取得成功，而手术组整体成功率为65%，肛门后修复术患者成功率为59%。肛门后修复术后，静息和“挤压”时的肛管压力以及肛管上部感觉均有所改善，但肛管直肠角无变化。我们得出结论，肛管直肠角对维持控便并非至关重要。
