Iwai N, Kaneda H, Tsuto T, Yanagihara J, Takahashi T
Nihon Geka Gakkai Zasshi. 1985 Sep;86(9):1297-300.
Functional results after surgical correction of anorectal malformations were assessed on a clinical basis following Kelly score, by manometric and radiologic studies. Sixty-five patients, older than 5 years, were personally interviewed and 51 of the 65 had manometric and radiologic studies to evaluate postoperative continence. Continent patients with high type lesions as well as those with low type lesions characteristically had a marked anorectal pressure difference and an acute anorectal angulation in the defecogram. On the other hand, in the patients with fair or poor results, neither a marked anorectal pressure difference nor anorectal angulation was found. These results indicate that achievement of continence in patients with a high type lesion treated by staged abdominoperineal rectoplasty depends upon bringing the terminal bowel down exactly within the sling of the puborectalis muscle.
通过凯利评分,在临床基础上,结合测压和放射学研究,对肛门直肠畸形手术矫正后的功能结果进行评估。对65名5岁以上的患者进行了个人访谈,其中51名患者接受了测压和放射学研究以评估术后控便能力。高类型病变的可控便患者以及低类型病变的患者在排粪造影中通常有明显的肛门直肠压力差和急性肛门直肠角。另一方面,在结果一般或较差的患者中,未发现明显的肛门直肠压力差和肛门直肠角。这些结果表明,经分期腹会阴直肠成形术治疗的高类型病变患者实现控便取决于将末端肠管准确地置于耻骨直肠肌吊带内。