诺布尔-门格特-菲什手术再探讨：一种针对持续性直肠阴道瘘和复杂会阴缺损的综合治疗方法
The Noble-Mengert-Fish operation-revisited: a composite approach for persistent rectovaginal fistulas and complex perineal defects.
作者信息
Veronikis D K, Nichols D H, Spino C
机构信息
Section of Urogynecology/Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, St John's Mercy Medical Center, St Louis, Missouri, USA.
出版信息
Am J Obstet Gynecol. 1998 Dec;179(6 Pt 1):1411-6; discussion 1416-7. doi: 10.1016/s0002-9378(98)70003-1.
OBJECTIVE
Our aims were to evaluate the full-thickness anterior rectal wall advancement flap in the treatment of primary and recurrent or persistent rectovaginal fistulas, evaluate the surgical exposure for composite repair of site-specific perineal defects, and categorize clinical manifestations of site-specific perineal defects caused by obstetric injury.
STUDY DESIGN
This is a prospective study of all patients with fecal incontinence from rectovaginal septal defects and complex perineal obstetric injuries treated by the Noble-Mengert-Fish operation.
RESULTS
Thirty-four patients were classified into groups on the basis of site-specific perineal defects. Anatomic success was 94.2%. Functional success was excellent in 76.5%, good in 14.7%, fair in 5.9%, and poor in 2.9%.
CONCLUSION
The Noble-Mengert-Fish operation is effective for primary and recurrent or persistent rectovaginal fistulas. The circumanal surgical exposure permits concomitant repair of all perineal defects.
目的
我们的目的是评估全层直肠前壁推进皮瓣在治疗原发性、复发性或持续性直肠阴道瘘中的应用，评估针对特定部位会阴缺损进行复合修复的手术暴露情况，并对产科损伤所致特定部位会阴缺损的临床表现进行分类。
研究设计
这是一项对所有因直肠阴道隔缺损和复杂产科会阴损伤导致大便失禁并接受诺布尔-门格特-菲什手术治疗的患者进行的前瞻性研究。
结果
34例患者根据特定部位会阴缺损进行分组。解剖学成功率为94.2%。功能成功率方面，优秀占76.5%，良好占14.7%，中等占5.9%，差占2.9%。
结论
诺布尔-门格特-菲什手术对原发性、复发性或持续性直肠阴道瘘有效。肛周手术暴露允许同时修复所有会阴缺损。
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