直肠末端旋转式瘘修补肛门成形术治疗先天无肛舟状窝瘘的研究

Fistula Repairment and Terminal-Rectum-Rotation Anoplasty in Treatment of Congenital Imperforate Anus With Rectal Fistula to Navicular Fossa

目的:采用直肠末端旋转式瘘修补肛门成形术(简称直肠末端旋转术)治疗先天无肛舟状窝瘘的研究并与几种术式疗效评价。方法:直肠末端旋转术102例。随机完成对照组48例,其中骶会阴、尾路肛门成形术20例,瘘后移肛门成形术28例。对两组患儿进行术后3个月～2年的随访。结果:直肠末端旋转术优97例,良5例,优良率95％,并发症5％对照组:优33例,良6例,差9例,优良率81.2％,并发症31.2％。其中骶会阴、尾路肛门成形术优13例,良3例,差4例;瘘后移肛门成形术优20例,良3例,差5例。研究组与对照组疗效经统计学检查,X^2值=17.16,P<0.001,直肠末端旋转术无瘘复发,对照组瘘复发6例,X^2值=14.81,P<0.001,有极显著性差异。结论:直肠末端旋转术解决了直肠回缩、瘘复发的发病基础,基本上避免了并发症的发生。

Purpose: Comparing the curative effects of fistula repairment and terminal-reclum-rotation anoplasty(TRRA) with other operation methods in the treatment of congenital imperfora te anus with rectal fistula to navicular fossa. Methods: 102 cases were treated with TRRA and 48 oases as control at random were treated respectively with sacrococcygeal-perineal anoplasty (20) and fistula retropostion anoplasty(28) . Postoperative follow-up periods of them were from 3 - 24 months. Resuls: Among the cases treated with TRRA, 97 were excellent, 5 good, the excellent and good rate was 95% ,5% ,had complcations.In the control group,33 were excellent,6 good,9 poor,the excellent and good rale was 81.2% ,31.2% had complications. In detail,among the cases treated with sacrococcygeal-perineal anoplsaty, 13 were excellent,3 good,4poor;among the cases treted wirh fistula retroposition anoplasty,20 were excellent,3 good,5 poor. Statistical analysis of the study group and the control group got X2 = 17.6, P < 0 001. S18 cases complicated with fistula recurrence in the control group bur cone in the TRRA group (X2 = 14.81, P < 0.001) . Conclusin;TRRA can eliminate the pathogenichasis of rectal retraction and fistula recurrence and avoid the occurrence of complications