中低位肛门直肠畸形的手术治疗(经会阴大W肛门肛管成形术)

Surgical treatment for middle and low level of anorectal anomaly:transperineal Da-W anoplasty

目的 研究治疗中低位肛门直肠畸形的简便易行疗效好的手术方法。方法 设计了经会阴前大W肛门肛管成形手术 ,用于治疗中低位肛门闭锁病人 ,包括有瘘 (会阴瘘、前庭瘘、阴道瘘、尿道瘘、会阴前肛门、肛门狭窄 )和无瘘病人。结果 40 / 42例伤口愈合好 ,首例术后早期会阴前纵切口裂开 ,中期 1例因感染整个切口裂开 ,延期愈合。绝大部分住院期间排便即恢复正常 ,全组无肛门失禁发生。结论 经会阴大W肛门肛管成形术是一种治疗中低位肛门直肠畸形的简便易行。

Objectives To obtain a simple, practical and effective method for surgical treatment of middle-low positioned anorectal anomaly.Methods We devised a new approach for transperineal Da-W anoplasty.42 cases of patients with fistula of rectovestibular, perineal, vagina, urethra and archostenosis, anterior anus of perineal and non-fistula patients received treatment.Results Of 42 patients 40 were cured during their stay in hospital;the wound in two cases were breached because of outside force and infection respectively, but healed not long after. Their anorectal function was good.Most of the cases had normal defecation and a few early-discharged patients restored to normal by follow-up. No anus incontinence in the treated group.Conclusion Da-W anoplasty is a simple, practical and effective method for surgical treatment of middle-low positioned anorectal anomaly.