克罗恩病中肛门阴道瘘的确定性修复
Definitive repair of anovaginal fistula in Crohn's disease.
作者信息
O'Leary D P, Milroy C E, Durdey P
机构信息
Department of Surgery, Bristol Royal Infirmary.
出版信息
Ann R Coll Surg Engl. 1998 Jul;80(4):250-2.
Anovaginal fistula may be a very distressing complication of Crohn's disease. We review the definitive repair of such fistulas in ten patients. The objectives were to cure the fistula, maintain continence and avoid proctectomy. The fistula was low trans-sphincteric in five patients, high trans-sphincteric in three and suprasphincteric in two. Loop ileostomies were formed in nine patients. Overall, after 14 repair procedures 8/10 fistulas are healed. Seven remain healed at a mean of 38 months (range 10-66 months) after ileostomy closure (six) or repair without ileostomy (one). All of the patients are continent. Definitive repair is effective and worthwhile in selected patients with Crohn's anovaginal fistula.
肛门阴道瘘可能是克罗恩病非常令人苦恼的并发症。我们回顾了10例此类瘘管的确定性修复情况。目标是治愈瘘管、维持控便能力并避免直肠切除术。5例患者的瘘管为低位经括约肌型，3例为高位经括约肌型，2例为括约肌上型。9例患者行袢式回肠造口术。总体而言，经过14次修复手术后，10例瘘管中有8例愈合。7例在回肠造口关闭（6例）或未行回肠造口修复（1例）后的平均38个月（范围10 - 66个月）仍保持愈合状态。所有患者均能控便。对于选定的克罗恩病肛门阴道瘘患者，确定性修复是有效且值得的。
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