自体肌肉移植重建人工肛门括约肌

Autologous muscle transplantation for reconstruction of artificial anal sphincter

背景:有效的人工肛门括约肌重建能够改善肛门失禁患者的生存能力和生活质量。目的:评价自体肌肉移植重建人工肛门括约肌的效果。方法:分析自体臀大肌和股薄肌移植重建人工肛门括约肌的解剖学基础,并对应用自体臀大肌和股薄肌移植重建人工肛门括约肌的患者进行随访观察,通过评估人工肛门控便功能恢复情况以及相关并发症发生情况,明确自体臀大肌和股薄肌移植重建人工肛门括约肌的应用效果。结果与结论:臀大肌和股薄肌均有丰富的血液供应,并且营养肌肉的动脉均有相应静脉和神经伴行。对应用自体臀大肌和股薄肌移植重建人工肛门括约肌的患者随访观察发现,患者多为直肠癌或者肛管癌,经过自体肌肉移植重建人工肛门括约肌后,均能获得较好的肛门排控便功能,较少发生肛门狭窄、肛周感染等并发症,无机体排斥反应的发生。

BACKGROUND： Effective artificial anal sphincter reconstruction can improve the survival and quality of life of patients with anal incontinence. OBJECTIVE： To evaluate the effect of autologous muscle transplantation on the reconstruction of artificia anal sphincter. METHODS： The anatomical basis of autologous gluteus maximus and gracilis transplantation for artificial ana sphincter reconstruction was analyzed, and the patients received artificial anal sphincter reconstruction with autologous gluteus maximus and gracilis transplantation were follow-up observed. The effect of autologous gluteus maximus and gracilis transplantation on artificial anal sphincter reconstruction was identified through evaluating the recovery of bowel control of artificial anus and the incidence of complications. RESULTS AND CONCLUSION： Both gluteus maximus and gracilis had the rich blood supply, and the arteries used to provide nutrition to the muscles had the corresponding veins and nerves accompanied. Thepatients received artificial anal sphincter reconstruction with autologous gluteus maximus and gracilis transplantation were follow-up observed and showed that the patients were mostly suffered colorectal cancer or anal cancer. After artificial anal sphincter reconstruction with autologous muscle transplantation, all the patients obtained good bowel control and defecation function with less anal stenosis, perianal infection or other complications, and no rejection was observed.