肛门直肠畸形患者后矢状入路肛门直肠成形术前后尿动力学检查的比较

Comparison of urodynamic investigations before and after posterior sagittal anorectoplasty for anorectal malformations.

作者信息

Kiliç N, Emir H, Sander S, Eliçevik M, Celayir S, Söylet Y

机构信息

Department of Pediatric Surgery, Cerrahpaşa Medical Faculty, University of Istanbul, Turkey.

出版信息

J Pediatr Surg. 1997 Dec;32(12):1724-7. doi: 10.1016/s0022-3468(97)90516-9.

DOI:10.1016/s0022-3468(97)90516-9

PMID:9434009

Abstract

METHODS

The authors evaluated 21 patients (10 boys, 11 girls) who had anorectal malformations (ARM). Ten of them had infralevator (low-group I) and 11 of them had supralevator (high-group II) type ARM. All of the patients underwent urodynamic investigation before and after posterior sagittal anorectoplasty (PSARP) operation.

RESULTS

Sacral and spinal anomalies were found in 54% (6 of 11) patients who had supralevator type ARM. None of the patients with infralevator type ARM had additional sacral or spinal anomalies. Before PSARP operation urodynamic investigations of all infralevator type ARM patients were within normal limits, whereas 82% (9 of 11) of patients with supralevator type ARM showed neurovesical dysfunction (NVD). There was no significant difference between the preoperative and postoperative urodynamic findings. The possibility of additional sacral or spinal anomalies and NVD in supralevator type ARM was high. After PSARP operation no additional lower urinary tract dysfunction was detected in the urodynamic evaluation of ARM patients.

摘要

方法

作者评估了21例患有肛门直肠畸形（ARM）的患者（10名男孩，11名女孩）。其中10例为肛提肌下型（低位I组），11例为肛提肌上型（高位II组）ARM。所有患者在经肛门后矢状入路直肠成形术（PSARP）手术前后均接受了尿动力学检查。

结果

在11例肛提肌上型ARM患者中，54%（6例）发现有骶骨和脊柱异常。肛提肌下型ARM患者均无额外的骶骨或脊柱异常。在PSARP手术前，所有肛提肌下型ARM患者的尿动力学检查均在正常范围内，而82%（11例中的9例）的肛提肌上型ARM患者表现为神经膀胱功能障碍（NVD）。术前和术后尿动力学检查结果无显著差异。肛提肌上型ARM患者出现额外骶骨或脊柱异常以及NVD的可能性很高。在PSARP手术后，ARM患者的尿动力学评估未发现额外的下尿路功能障碍。