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目的:采用直肠末端旋转式瘘修补肛门成形术(简称直肠末端旋转术)治疗先天无肛舟状窝瘘的研究并与几种术式疗效评价。方法:直肠末端旋转术102例。随机完成对照组48例,其中骶会阴、尾路肛门成形术20例,瘘后移肛门成形术28例。对两组患儿进行术后3个月～2年的随访。结果:直肠末端旋转术优97例,良5例,优良率95％,并发症5％对照组:优33例,良6例,差9例,优良率81.2％,并发症31.2％。其中骶会阴、尾路肛门成形术优13例,良3例,差4例;瘘后移肛门成形术优20例,良3例,差5例。研究组与对照组疗效经统计学检查,X~2值=17.16,P<0.001,直肠末端旋转术无瘘复发,对照组瘘复发6例,X~2值=14.81,P<0.001,有极显著性差异。结论:直肠末端旋转术解决了直肠回缩、瘘复发的发病基础,基本上避免了并发症的发生。
OBJECTIVE: To study the treatment of congenital anastomotic-type fistula with anal fistula rectal angioplasty (referred to as rectal terminal rotation) and evaluate the efficacy of several surgical procedures. Methods: 102 cases of rectal terminal rotation. Forty-eight cases were randomly divided into control group, including 20 cases of sacral perineum, caudal anoplasty and 28 cases of anal anoplasty. Two groups of children after 3 months to 2 years follow-up. Results: The results of rectal rotation were excellent in 97 cases and good in 5 cases. The excellent and good rate was 95% and the complication rate was 5%. The control group was excellent in 33 cases, good in 6 cases and poor in 9 cases. The excellent and good rate was 81.2% and the complication was 31.2%. Among them, sacral perineal and caudal anoplasty were excellent in 13 cases, good in 3 cases and poor in 4 cases. Fistula transanal anoplasty was excellent in 20 cases, good in 3 cases and poor in 5 cases. The results of the study group and the control group were statistically analyzed. The X ~ 2 value was 17.16, P <0.001. There was no fistula recurrence in the rectal terminal spine. The control group had 6 cases of recurrence of fistula, X ~ 2 = 14.81, P <0.001, Significant difference. Conclusion: Rectal distal rotation solves the basis of rectal retraction and fistula recurrence, and basically avoids the occurrence of complications.