肛管皮肤黏膜搭桥术治疗肛管上皮缺损(附11例报告)

The treatment for anal skin defect by anornucocutaneous bypass surgery

目的 :探讨肛管皮肤黏膜搭桥术治疗肛管上皮缺损的疗效。方法 :手术方式为于肛缘外正常皮肤部位游离 3 5cm× 1 5cm长方形带蒂全层皮瓣、内端游离黏膜 0 5cm× 1 5cm ,切除对应部位肛管处瘢痕组织 ,将皮瓣与黏膜瓣缝合覆盖创面。结果 :1 1例皮肤黏膜瓣均存活 ,1 0例治愈 ,1例好转。结论 :肛管皮肤黏膜搭桥术治疗肛管上皮缺损具有疗效好 ,取材方便 ,皮瓣存活率高、弹性好、伸展性好 ,术后肛门不变形等优点 ,是治疗肛管上皮缺损较理想的术式 ,但对肛缘外皮肤大面积缺损。

Objective:To discuss the effectiveness of treatment for anal skin defect by anornucocutaneous bypass surgery. Methods:The 11 cases of anal skin defect were treated by surgery which uses the long square normal skin flap (full layers, 3 5cm×1 5cm) and mucus (0 5cm×1 5cm) freed from the normal tissues near the anal verge, then sutured to cover the defect after excision of the anal scar.Results:The skin flaps and mucuses of 11 cases survived well (10 healed completely,1 got better).Conclusion:Anomucocutaneous bypass surgery has many advantages in treating the anal skin defect such as good effectiveness, convenient to getting surgical materials, high survival rate of the skin flap, good elastic and extension of tissues and no anal deformity after surgery, etc. The operation is an ideal way to treat anal skin defect, but not suitable for the large anal skin defect and the region without enough skin flap.