González A R, de Oliveira O, Verzaro R, Nogueras J, Wexner S D
Department of Colorectal Surgery, Cleveland Clinic Florida, Fort Lauderdale 33309, USA.
Am Surg. 1995 Jun;61(6):526-9.
Anorectal strictures have been a serious problem for many years. The aim of this study was to determine the experience with anoplasty in our institution. A group of 17 patients, (six males and 11 females) were evaluated between May 1989 and February 1994, with an age range of 20 to 78 (mean 61 years). The main symptoms were difficulty to pass stool or constipation in 10 patients (58.8 per cent), rectal bleeding in eight patients (47 per cent), and anorectal pain in seven patients (41.1 per cent). The patients underwent clinical examination and the findings were anal stenosis in 13 patients (76.4 per cent), perianal fistula in two patients (11.8 per cent), key hole deformity in one patient (5.9 per cent), and unhealed chronic fissure in one patient (5.9 per cent). The technical procedure was S plasty in six patients (35.2 per cent) and advancement flaps in 11 (64.8 per cent). The follow-up period was between 3 and 59 (mean 18) months. In 16 patients, surgery had good results with improvement of their preoperative symptoms and preservation of continence. There was one septic complication; mean hospital stay was 3 days. In conclusion, anoplasty appears to be a safe and successful alternative for the treatment of anal stenosis.
多年来,肛门直肠狭窄一直是个严重问题。本研究的目的是确定我院肛门成形术的经验。1989年5月至1994年2月期间对一组17例患者(6例男性和11例女性)进行了评估,年龄范围为20至78岁(平均61岁)。主要症状为10例患者(58.8%)排便困难或便秘、8例患者(47%)直肠出血、7例患者(41.1%)肛门直肠疼痛。患者接受了临床检查,结果显示13例患者(76.4%)存在肛门狭窄、2例患者(11.8%)存在肛周瘘、1例患者(5.9%)存在锁孔畸形、1例患者(5.9%)存在未愈合的慢性肛裂。技术操作方面,6例患者(35.2%)采用S形整形术,11例患者(64.8%)采用推进皮瓣术。随访期为3至59个月(平均18个月)。16例患者手术效果良好,术前症状得到改善且控便功能得以保留。发生了1例感染并发症;平均住院时间为3天。总之,肛门成形术似乎是治疗肛门狭窄的一种安全且成功的选择。