Browning G G, Motson R W
Br Med J (Clin Res Ed). 1983 Jun 11;286(6381):1873-5. doi: 10.1136/bmj.286.6381.1873.
Parks operation for faecal incontinence was performed on 97 patients with total loss of anorectal control due to injury. All had sustained complete division of the anal sphincters as a result of trauma, anal surgery, or obstetric tears and either were incontinent or had been given a colostomy. In all patients the divided sphincters were repaired using an overlapping technique; in 93 the repair was protected by a temporary defunctioning stoma. There was no operative mortality. Continence was completely restored in 65 (78%) and improved in a further 11 (13%) of the 83 patients assessed from four to 116 months postoperatively. Minor complications which did not affect the eventual clinical outcome occurred in 23 patients. Factors associated with failure of the operation included breakdown of the repair in the early postoperative period, fistula, and pelvic floor neuropathy. The results show that even after severe injury to the sphincters surgical reconstruction can restore continence in most patients.
对97例因损伤导致肛门直肠控制功能完全丧失的患者实施了帕克斯粪便失禁手术。所有患者均因外伤、肛门手术或产科撕裂而导致肛门括约肌完全断裂，且均存在大便失禁或已接受结肠造口术。所有患者均采用重叠技术修复断裂的括约肌；93例患者的修复通过临时造口进行保护。无手术死亡病例。在术后4至116个月接受评估的83例患者中，65例（78%）的控便功能完全恢复，另有11例（13%）有所改善。23例患者出现了不影响最终临床结局的轻微并发症。与手术失败相关的因素包括术后早期修复失败、肛瘘和盆底神经病变。结果表明，即使括约肌受到严重损伤，手术重建仍可使大多数患者恢复控便功能。
