Hamada Y, Mori T, Tanano A, Kato Y, Takada K, Sato M, Sanada T, Tsuji M, Kogata M, Hioki K
Second Department of Surgery, Kansai Medical University, Osaka, Japan.
Surg Today. 1996;26(10):814-7. doi: 10.1007/BF00311643.
We report herein the case of an infant with anorectal stenosis successfully treated by staged surgery. At 1 day of age, the anal orifice showed circumferential stenosis located 5 mm from the anal verge and extending into the anal canal for approximately 1 cm; however, no hypertrophic raphe or bucket handle appearance were observed, and no associated anomalies such as a presacral mass or sacral dysgenesis were found. At 2 days of age, the infant underwent a sigmoid colostomy under the diagnosis of low anorectal stenosis, followed by a successful anorectoplasty, performed through a sacroperineal approach when he was 8 months old. An analysis of 13 other cases of anorectal stenosis from the Japanese literature indicates that this type of malformation should be treated by staged surgery, as an initial colostomy in the neonatal period, followed by anorectoplasty through a sacroperineal approach during infancy.
我们在此报告一例通过分期手术成功治疗的肛门直肠狭窄婴儿病例。出生1天时,肛门孔显示为环形狭窄,位于距肛缘5毫米处,并延伸至肛管约1厘米;然而,未观察到肥厚性缝或桶柄样外观,也未发现骶前肿物或骶骨发育不全等相关异常。出生2天时,该婴儿在低位肛门直肠狭窄的诊断下接受了乙状结肠造口术,随后在8个月大时通过骶会阴入路成功进行了肛门直肠成形术。对日本文献中其他13例肛门直肠狭窄病例的分析表明,这种类型的畸形应采用分期手术治疗,即在新生儿期先行结肠造口术,然后在婴儿期通过骶会阴入路进行肛门直肠成形术。