Webb H W, Barraza M A, Stevens P S, Crump J M, Erhard M
Department of Surgery, Nemours Children's Clinic, Jacksonville, Florida 32207, USA.
Eur J Pediatr Surg. 1998 Dec;8 Suppl 1:37-8. doi: 10.1055/s-2008-1071251.
Fecal incontinence remains a detriment to improved quality of life in many patients with spina bifida. Previous methods of conservative management frequently prove to be inadequate, causing many patients to withdraw from the social mainstream. Recent descriptions of procedures to provide access to the proximal colon for antegrade colonic enemas (ACE procedure) have provided a new approach to managing fecal incontinence. We report here our experience with these procedures in 43 patients with spina bifida. The background, techniques and outcomes of these procedures are discussed and a plea is made to consider this approach in all patients who are hampered in their social or vocational progress because of neurogenic anorectal dysfunction.
大便失禁仍然是许多脊柱裂患者提高生活质量的一大障碍。以往的保守治疗方法常常被证明是不够的，导致许多患者退出社会主流。最近关于为顺行结肠灌肠（ACE手术）提供近端结肠通路的手术描述，为大便失禁的管理提供了一种新方法。我们在此报告我们对43例脊柱裂患者进行这些手术的经验。讨论了这些手术的背景、技术和结果，并呼吁对所有因神经源性肛门直肠功能障碍而在社交或职业发展中受阻的患者考虑采用这种方法。
