Freeman N V, Bulut M
J Pediatr Surg. 1986 Mar;21(3):218-20. doi: 10.1016/s0022-3468(86)80837-5.
Between 1973 and 1983, 18 patients with "high" anorectal anomalies were treated by one of the authors (N.V.F.) by immediate sigmoid loop-colostomy, followed by a sacroperineal or abdominosacroperineal pull-through operation as soon as possible thereafter. This was performed in seven patients between 1 and 14 days, in seven patients between 15 and 40 days, and in four patients between 60 and 120 days. Daily anal dilatations were started 7 to 10 days postoperatively and continued until the anus was soft and supple. The colostomy was then closed, the aim being to complete all treatment by the age of 3 to 4 months. Continence was assessed using Kiesewetter's criteria. Results in 70% were "good", 18% "fair", and 12% "poor". The clinical results are discussed together with the possible advantages of definitive surgery in the neonatal period for "high" anorectal anomalies.
1973年至1983年间，作者之一（N.V.F.）对18例“高位”肛门直肠畸形患者进行了急诊乙状结肠袢式造口术治疗，随后尽快进行骶会阴或腹骶会阴拖出术。7例患者在术后1至14天进行了该手术，7例患者在术后15至40天进行，4例患者在术后60至120天进行。术后7至10天开始每日进行肛门扩张，并持续至肛门柔软灵活。然后关闭结肠造口，目标是在3至4个月龄时完成所有治疗。使用基泽韦特标准评估控便情况。结果显示，70%为“良好”，18%为“尚可”，12%为“差”。本文讨论了临床结果以及新生儿期对“高位”肛门直肠畸形进行确定性手术可能存在的优势。
