改良PPH术治疗成人直肠阴道瘘(附30例报告)

Modified PPH in the treatment of rectovaginal fistula in adults:Report of 30 cases

目的探讨治疗成人直肠阴道瘘的方法。方法对30例直肠阴道瘘患者实施了改良PPH术治疗。术中修剪直肠黏膜层瘘口边缘﹑然后连续缝合边缘,再做直肠前半环黏膜层荷包,实施PPH术,直肠后壁黏膜用隔离胶片隔离保护。结果30例全部一期愈合,术后随访1～3年,无复发。结论改良PPH术具有手术视野清晰,易操作,不损伤会阴体和肛门括约肌,手术创伤小,不复发等优点,是治疗成人直肠阴道瘘较为理想的术式。

Objective To explore the treatment of rectovaginal fistula in aduhs.Methods Modified PPH was adopted in 30 patients with rectovaginal fistula, i.e triming the edge of fistula opening at the rectal mucosal level and then continually suturing the edge, making a pouch at the former half mucosal level of recta, then PPH was adopted, the back mucous membrane of recta was separated and protected by isolated film.Results All the 30 patients have been cure^l for once and followed up for 1-3 years, no relapse was found. Conclusion The modified PPH has the following advantages： clear operational field, easy to operate, no damage to perineum and anal sphincter, less operative trauma, no relapse etc. it is an idea way in the treatment of rectovaginal fistula in adults.