无肛舟状窝瘘术式改良及疗效评价

MODIFICATION OPERATION ON IMPERFORATE ANUS WITH RECTAL FISTULA TO NAVICULAR FOSSA AND EVALUATION ITS CURATIVE EFFECT

目的:无肛舟状窝瘘术式改良及疗效评价。方法:采用直肠末端旋转术并得到随访102例。完成对照组并得到随访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。结果:直肠末端旋转术优97例,良5例。治愈率95%,并发症发生率5％。对照组:优33例、良6例、差9例、治愈率68.8％,并发症发生率31.2％。直肠末端旋转术与对照组疗效比较采用X^2检验,X^2=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=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,避免了并发症的发生。近远期随访结果满意。

To evaluate curative effect modification operation on imperforate anus with rectal fistula to navicular fossa. Methods: 102 cases were treated with terminal-rectum-rotation anoplasty (TRRA) and 48 cases as control at random were treated respectively with sacrococ-cygeal-perineal anoplasty (20) and fistula retroposition anoplasty (28). All cases had been followed up postoperatively. Results: Among the cases treated with TRRA, 97 showed excellent results and 5 good results, with 100% curative rate and 5% complications. In the control group, 33 showed excellent results, 6 good and 9 poor, with 68. 8% curative rate and 31. 2% complications. Statistical analysis of the study group and the control group by way of X2 test demonstrated X2= 17. 16, P <0. 001. Six cases were complicated with fistula recurrence in the control group but none in the TRRA group (X2 = 14. 81, P <0. 001). Conclusion: TRRA can eliminate the pathogenichasis of rectal retraction and fistula recurrence and avoid occurrence of complications. Its short-term and long-term follow-up result is satisfactory. It has been introduced to many hospitals in the country and has produced significant therapeutic results.