頁籤選單縮合
題名 | The Experience of Limited Posterior Sagittal Anorectoplasty for LowImperforate Anus=以侷限性後矢狀肛門直腸成形術(limited PSARP)治療低位無肛症之經驗 |
---|---|
作者姓名(中文) | 王桂良; 林哲男; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 26:1 民82.01-02 |
頁次 | 頁1574-1579 |
分類號 | 417.6248 |
關鍵詞 | 後矢狀肛門直腸成形術; 低位無肛症; Low anorectal anomaly; Posterior sagittal anorectoplasty; Imperforate anus; |
語文 | 英文(English) |
中文摘要 | 在1986年至1991年間,本院共有21例低位無肛症接受limited PSARP的治療,其中17例為直接手術,其餘4例則曾接受過後切肛門成形術(Cutback),但結果不理想而再次接受手術。所有的病例均無其他嚴重之先天性異常,且其薦骨皆正常。大部分的病例接受limited PSARP時均無人工結腸造瘻只有3例直接手術的病人曾接受過人工結腸瘻手術,其中2例是因其剛出生時經診斷為高位無肛症,另1例則是因轉送至本院時已發生乙狀結腸破裂。此報告中只有一例再次手術的病人發生輕微的傷口發炎,然而經過治療之後,很快即痊癒。所有的病例均經過6個月到5年的追蹤。所有直接手術的病人均對其術後之外觀相當滿意,而再次手術的病人也很滿意其外觀的改善。本報告中,年齡大於3歲的病例均接受排便機能的評估,其中包括5例直接手術及4例再次手術的病人。接受評估時,均暫停使用灌腸、肛門塞劑或口服瀉劑。九例病人當中,全部均有自主性排便動作。雖然有2例直接手術及1例再次手術的病人有輕微(Grade I)之便秘(constipation)或糞污現象(soiling),但均很容易經由飲食或口服瀉劑而得到緩解。由此報告發現,以limited PSARP來治療低位無肛症,手術本身簡單又安全,且無論是外觀或排便機能,其成果均相當令人滿意。 |
英文摘要 | Posterior sagittal anorectoplasty (PSARP), described by Pena and deVries in 1982, has been considered an excellent approach for treatment of an imperforate anus. From 1986 to 1991, 21 patients with low imperforate anus were operated upon in our institution using a limited PSARP. Among them, 17 patients underwent primary limited PSARP, while 4 others had secondary operation for a previous unsatisfactory cutback procedure. All patients had a normal sacrum, and no other serious associated anomalies. Three primary patients had colostomies done; two for the initial diagnosis of higher type anomaly, and one for sigmoid colon perforation. Minor wound infection occurred in one of the secondary patients, but this was healed by the time of discharge. Follow-up ranged from six months to five years. All patients were satisfied with the cosmetic appearance of the perineum. Five primary patients and all four secondary patients who were older than three use of enemas, laxatives or suppositories. Voluntary bowel movements occurred in all nine patients. Two primary patients and one secondary patient had a mild degree of soiling or constipation, but this could be easily managed by diet or laxatives. This study suggests that limited PSARP has good results for either cosmesis or bowel control. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。