Department of Surgery, Division of Paediatric Surgery, Federal Medical Center, Yola, Adamawa State, Nigeria.
Department of Surgery, Pediatric Surgery Unit, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria.
Afr J Paediatr Surg. 2023 Apr-Jun;20(2):89-92. doi: 10.4103/ajps.ajps_170_21.
Anal dilation with Hegar dilator is recommended as part of the post-operative management following surgical correction of anorectal malformation (ARM) in children to prevent strictures. Parents usually continue dilation at home with a personal set of dilators. However, in low-resource settings, many parents cannot afford the Hegar dilator. Devices that have been improvised as dilators include appropriately sized candles, spigot from Foley catheter, rounded ball pen ends and mothers' fingers. We aimed to report our preliminary experience with the use of candle as an improvised anal dilator following surgeries for ARM in our practice.
A review of records of children who had surgery for ARMs and commenced on candle dilation between February 2018 and July 2019 at our centre was done. Relevant demographic information, type of anomaly, duration of dilation, availability of health insurance coverage, complications and parents' acceptance of improvised dilator (evaluated during scheduled follow up visits) were retrieved. The data were analysed using SPPSS version 21 (Chicago, Illinois).
Nineteen patients underwent anal dilation with improvised candles during the period. Rectobulbar and rectovestibular fistulas were most frequent anomaly in boys and girls, respectively. The median age at surgery was 6 months. The median duration of dilation (completed in 9 patients) was 7 months. Candle dilation was well tolerated, and all parents were comfortable using the device.
The candle as an improvised anal dilator following anorectal surgeries in children is a useful alternative to the conventional dilator. It is more affordable and gives satisfactory results.
在儿童肛门直肠畸形（ARM）手术后的术后管理中，建议使用 Hegar 扩张器进行肛门扩张，以预防狭窄。家长通常在家中使用个人一套扩张器继续进行扩张。然而，在资源匮乏的环境中，许多家长无法负担 Hegar 扩张器的费用。被改装成扩张器的器械包括大小合适的蜡烛、 Foley 导管的旋塞、圆形圆珠笔末端和母亲的手指。我们旨在报告我们在实践中使用蜡烛作为 ARM 手术后的一种临时肛门扩张器的初步经验。
对 2018 年 2 月至 2019 年 7 月期间在我们中心接受 ARM 手术并开始使用蜡烛扩张的儿童的记录进行了回顾。检索了相关的人口统计学信息、异常类型、扩张持续时间、健康保险覆盖情况、并发症以及家长对临时扩张器的接受程度（在预定的随访期间评估）。使用 SPSS 版本 21（伊利诺伊州芝加哥）对数据进行分析。
在该期间，有 19 名患者接受了临时蜡烛扩张。男孩中最常见的异常是直肠膀胱瘘，女孩中最常见的异常是直肠阴道瘘。手术时的中位年龄为 6 个月。完成 9 例患者的中位扩张持续时间为 7 个月。蜡烛扩张耐受性良好，所有家长都能舒适地使用该设备。
在儿童肛门直肠手术后，蜡烛作为一种临时肛门扩张器是传统扩张器的有用替代品。它更经济实惠，效果令人满意。
