Iwai N, Hashimoto K, Kaneda H, Tsuto T, Yanagihara J, Majima S
Z Kinderchir. 1983 Oct;38(5):316-9. doi: 10.1055/s-2008-1059996.
Anorectal manometric studies were performed on 15 patients with Hirschsprung's disease before surgery, on eight patients after Rehbein's procedure and seven patients after Rehbein's procedure with anorectal myectomy. The results were compared with those of 45 normal subjects. High anal resting pressure as well as an absence of the anorectal reflex proved to be responsible for obstructive symptoms in Hirschsprung's disease. Out of eight patients treated according to Rehbein's procedure, new internal sphincter relaxation was found in two, and anal resting pressures were significantly higher than those of the normal controls or of the patients treated according to Rehbein's procedure plus anorectal myectomy. It was demonstrated that anorectal myectomy is a more definitive procedure to restore the anal resting pressure to normal. Good postoperative continence can be achieved not only by the new internal sphincter relaxation but also by good propulsive movement which can overcome the remaining functional obstruction.
对15例先天性巨结肠症患者在手术前、8例接受雷贝因手术的患者以及7例接受雷贝因手术加肛门直肠肌切除术的患者进行了肛门直肠测压研究。将结果与45名正常受试者的结果进行比较。高肛管静息压以及肛门直肠反射消失被证明是先天性巨结肠症梗阻症状的原因。在8例按照雷贝因手术治疗的患者中，发现2例有新的内括约肌松弛，且肛管静息压明显高于正常对照组或接受雷贝因手术加肛门直肠肌切除术的患者。结果表明，肛门直肠肌切除术是使肛管静息压恢复正常的更确切的手术。术后不仅可以通过新的内括约肌松弛，还可以通过良好的推进运动来克服剩余的功能性梗阻，从而实现良好的控便能力。
