| 张燕敏,刘翔,左伟,等.小儿先天性肛门直肠畸形术后直肠黏膜脱垂30 例[J].安徽医药,2022,26(9):1843-1845. |
| 小儿先天性肛门直肠畸形术后直肠黏膜脱垂30 例 |
| Thirty cases of postoperative rectal mucosal prolapse in children with congenital anorectal malformation |
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| DOI：10.3969/j.issn.1009-6469.2022.09.034 |
| 中文关键词: 直肠脱垂 肛门直肠畸形 手术后并发症 |
| 英文关键词: Rectal prolapse Anorectal malformations Postoperative complications |
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| 中文摘要: |
| 目的总结先天性肛门直肠畸形术后病儿直肠黏膜脱垂处理经验。方法回顾性分析总结在安徽省儿童医院2014年4月至2020年12月期间先天性肛门直肠畸形术后直肠黏膜脱垂行相关治疗的30例病儿资料。其中6例发生于肛门一期成形术后，5例继发于腹腔镜肛门成形术后，17例继发于后矢状入路经骶会阴肛门成形(Pena)术后，2例发生于泄殖腔畸形矫治术后，依据肛门外括约肌的情况，分别行切除脱垂直肠黏膜和修复加强外括约肌。结果30例先天性肛门直肠畸形病儿术后随访6个月至7年，除1例在直肠黏膜脱垂术后1个月发生肛门狭窄，其余治疗效果满意，无复发及术后瘢痕等并发症，肛门收缩力良好。结论直肠黏膜脱垂多发生于肛门成形术后半年之内，需要长期随访。根据肛门外括约肌的收缩能力来切除脱垂直肠黏膜并修复括约肌环，可获得满意的外观，预后较好。 |
| 英文摘要: |
| Objective To summarize the experience in the management of rectal mucosal prolapse in children with congenital anorectal malformation after surgery.Methods A retrospective analysis was conducted to summarize the data of 30 children with rectal prolapse after surgery for congenital anorectal malformation in Anhui Provincial Children's Hospital from April 2014 to December 2020. Among them, 6 cases occurred after primary anal anoplasty, 5 cases occurred after laparoscopic anoplasty, 17 cases occurred after posterior sagittal anorectoplasty (PSARP), and 2 cases occurred in the cloaca after deformity correction. According to the condition of the external anal sphincter, resection of the vertical intestinal mucosa and repair and strengthening of the external sphincter were performed.Results Thirty children with congenital anorectal malformation were followed up for 6 months to 7 years after the operation.Except for 1 patient who developed anal stenosis 1 month after rectal mucosal prolapse, the rest of the treatment results were satisfactory,there were no complications, such as recurrence and postoperative scars, and the anal contractility was good.Conclusions Rectal mucosal prolapse usually occurs within half a year after anoplasty and requires long-term follow-up. According to the contractility of the external anal sphincter, the excision of the vertical intestinal mucosa and the repair of the sphincter ring can obtain a satisfactory appearance and a good prognosis. |
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