Baranov K N, Lëniushkin A I, Lukin V V, Pankevich T L
Khirurgiia (Mosk). 1993 Aug(8):49-53.
The work analyses the causes of insufficient air-tightness of the anal canal in the postoperative period (in children operated on for anorectal developmental anomalies), which leads to anal incontinence. The authors suggest a method for anoplasty based on: (1) performance of sphincteroplasty with consideration for the function of three muscles forming the external sphincter of the anal canal; (2) formation from the musculo-serous coat of the intestine subjected to the pull-through procedure a soft elastic pad lining the canal on the inside; (3) creating conditions for adherence of the mucous coat of the intestine to the walls of the neoanal canal. Manometric, CT, and ultrasonic special methods of examination showed that with the use of the suggested method the obturative pressure in the neoanal canal increases, "prolapse" of the mucosa of the operated on intestine is prevented, the accumulative and evacuative functions of the rectum are improved. The causes and errors which led to poor results (2 cases) are analysed. In the remaining 42 cases the results were good and satisfactory.
该研究分析了术后（接受肛门直肠发育异常手术的儿童）肛管气密性不足的原因，这会导致肛门失禁。作者提出了一种肛门成形术方法，其基于：（1）考虑构成肛管外括约肌的三块肌肉的功能进行括约肌成形术；（2）从接受拖出术的肠管肌浆层形成一个柔软的弹性垫，衬于肛管内部；（3）为肠黏膜与新肛管壁的粘连创造条件。压力测量、CT和超声等特殊检查方法表明，使用所建议的方法可使新肛管的闭锁压力增加，防止手术肠段黏膜“脱垂”，改善直肠的贮积和排空功能。分析了导致不良结果（2例）的原因和失误。其余42例结果良好且令人满意。
