房形推移皮瓣修复术治疗15例肛肠术后中重度肛门狭窄患者的临床疗效观察

“House”advancement pedicle flap for moderate to severe anal stenosis following anorectal surgery: an analysis of 15 cases

目的 探讨房形推移皮瓣修复术治疗肛肠术后中重度肛门狭窄的临床疗效。方法 回顾性分析2019年1月至2021年5月于我科行房形推移皮瓣修复术治疗的15例肛肠术后中重度肛门狭窄患者的临床资料,记录手术相关指标及术后随访情况。结果15例患者中,平均手术时间为(83.7±27.9) min,平均术后首次排粪时间为(3.3±1.0) d,中位住院时间为10 (6,12) d。有5例患者术后发生并发症,包括2例缝合处部分裂开、1例血肿形成、1例切口感染、1例少许皮瓣坏死。5例发生术后并发症的患者在接受对症治疗后切口均完全愈合。15例患者的皮瓣全部成活。术后平均随访时间为(9.9±5.2)个月,均无肛门狭窄复发。结论 房形推移皮瓣修复术治疗中重度肛门狭窄的成功率较高,操作相对简单,安全性良好。

Objectives To investigate the clinical effectiveness of“House”advancement pedicle flap for moderate to severe anal stenosis following anorectal surgery. Methods This was a retrospective analysis of 15 patients with moderate to severe anal stenosis following anorectal surgery treated with "House" advancement pedicle flap at our department between January 2019 and May 2021. Surgical details and postoperative follow-up were recorded. Results Of the 15 patients, the mean(SD) duration of surgery was 83.7(27.9) minutes;the mean(SD) time to the first postoperative bowel movement was 3.3(1.0) days;the median duration of hospitalization was 10(6, 12) days. Five patients experienced postoperative complications, including two wound dehiscence, one hematoma, one incision infection, and one flap necrosis. Wounds healed uneventfully in five patients after targeted treatment.Flap survived in all 15 patients. Patients were followed up postoperatively for a mean(SD) of 9.9(5.2) months, and none had recurrence. Conclusion “House”advancement pedicle flap is a relatively simple and safe procedure for moderate to severe anal stenosis following anorectal surgery with a high success rate.