Sobrado C W, Nahas S C, da Silva e Souza Júnior A H, Habr-Gama A
Departamento de Gastroenterologia da Faculdade de Medicina da Universidade de São Paulo.
Rev Hosp Clin Fac Med Sao Paulo. 1998 Jul-Aug;53(4):205-13.
The management of anal incontinence varies. It can be treated either clinically or surgically depending on its etiology and the intensity of the signs and symptoms. The variety of procedures and techniques employed in its treatment is proof of the incomprehension of the pathophysiological mechanisms involved as well as their diversity. Sphincteroplasties are indicated for those patients with well-defined muscle injury, usually resulting from obstetrical trauma, iatrogenic surgery or vehicular accidents. In cases of persistent anal incontinence after previous sphincteroplasty or those in which extensive destruction of the sphincteric musculature is confirmed, muscle-aponeurotic transpositions are an attractive option. A detailed survey of the literature of the chief techniques utilized and their results is presented.
肛门失禁的治疗方法多种多样。根据其病因以及体征和症状的严重程度,可采用临床治疗或手术治疗。治疗中所采用的各种手术程序和技术,证明了人们对其中涉及的病理生理机制及其多样性缺乏理解。括约肌成形术适用于那些肌肉损伤明确的患者,这些损伤通常由产科创伤、医源性手术或交通事故引起。对于先前括约肌成形术后仍持续存在肛门失禁的患者,或已证实括约肌肌肉组织广泛受损的患者,肌肉-腱膜转位术是一个有吸引力的选择。本文对主要使用的技术及其结果进行了详细的文献综述。