腹腔镜辅助肛门成形术治疗高位直肠肛门畸形15例临床观察  

Clinical observation of laparoscopic assisted anal plasty for 15 cases of high anorectal malformation

作　　者：钟健[1] 肖志华[1] 陈小梅[1] 岑君[1] 罗元胜[1] 黎兆攀 

机构地区：[1]广西玉林市第一人民医院小儿外科,广西玉林537000

出　　处：《中国医学工程》2017年第10期25-27,共3页China Medical Engineering

摘　　要：目的探讨腹腔镜辅助肛门成形术治疗高位肛门闭锁的价值。方法选取15例诊断先天性高位肛门闭锁患儿为研究对象,15例研究对象新生儿期均行结肠造瘘,二期均行腹腔镜辅助下肛门成形术,3个月后关闭结肠造瘘口。术后随访12~24个月,采用临床评分标准(6分法)评估肛门排便功能。结果 15例研究对象均顺利完成腹腔镜辅助肛门成形术,手术时间60~90 min,出血5~10 ml,术后均获得良好肛门外形,术后均随访12~24个月,经临床评分标准(6分法)评估肛门排便功能,结果为优10例,良5例;术后并发症2例,均为直肠黏膜脱垂。结论腹腔镜辅助肛门成形术是目前治疗高位肛门闭锁疗效确定的一种手术方式,手术创伤小,对盆底肌肉的损伤小,可获得良好的肛门外形和排便功能。【Objective】To evaluate the value of laparoscopic assisted anal plasty in the treatment of high anal atresia. 【Methods】Fifteen cases of congenital high imperforate anus were selected as the research objects. Colostomy was performed in all 15 cases at the neonatal stage. They underwent laparoscopic assisted anal plasty in the second stage, and the colostomy was closed 3 months later. The patients were followed up for 12~24 months, and the defecation function of the anus was evaluated by the clinical scoring standard（six points method）.【Results】Fifteen cases were successfully completed laparoscopically assisted anoplasty, operation time was 60~90 min, the amount of bleeding was 5~10 ml, good anal appearance after surgery was obtained, patients were followed up for 12~24 months, anal function was assessed using the clinical standard for evaluation, 10 cases was excellent, 5 cases was good, and postoperative complication of rectal mucosal prolapse was found in 2 cases.【Conclusion】Laparoscopic assisted anoplasty is a surgical method in the treatment of high anal atresia with determined curative effect, small surgical trauma and pelvic floor muscle damage, which can obtain good anal shape and defecation function.

关 键 词：腹腔镜 肛门闭锁 肛门畸形 

分 类 号：R726.2[医药卫生—儿科]