PDF(Pubmed)
Abstract：
UNASSIGNED: To assess the effect of megarectum on postoperative defecation of female patients with congenital rectovestibular fistula or rectoperineal fistula.
UNASSIGNED: From March 2013 to February 2021, 74 female patients with congenital rectovestibular fistula or rectoperineal fistula were treated. The age of patients ranged from 3 months to 1 year. Barium enema and spinal cord MRI were performed in all children. 4 patients were removed from the study because of spinal cord and sacral agenesis. Finally, 70 patients underwent one-stage anterior sagittal anorectoplasty (ASARP). Anal endoscopy and anorectal pressure measurement were performed 1 year after surgery. All patients were divided into two groups depending on the presence of megarectum (+) and (-) and observed for constipation and anal sphincter function.
UNASSIGNED: 16 patients (4 months to 1 year) were complicated with megarectum, and 5 patients (3 months to 9 months) were without megarectum. The incision infection was seen in 3 patients. All patients were followed up for 1 year to 5 years. Fecal soiling was seen in 2 patients and constipation in 14 patients. Among 16 patients with megarectum, soiling was seen in 1 patient and the constipation in 12 patients. Among 54 patients without megarectum, soiling was seen in 1 patient and constipation in 2 patients. There was a significant difference in the incidence of postoperative constipation between the two groups (megarectum (+) 75% vs. megarectum (-) 3.7% (P < 0.05)). However, there was no significant difference in the score of anal sphincters between the two groups (P < 0.05). And there was no significant difference in anal resting pressure (P = 0.49) and length of anal high pressure area (P = 0.76). 7 patients with constipation and megarectum acquired normal anal function after the dilated rectum was resected.
UNASSIGNED: Megarectum increases the possibility of difficult postoperative defecation in the patients with congenital rectovestibular fistula or rectoperineal fistula. However, constipation was not associated with ASARP postoperative effects on sphincter function. Resection of megarectum is helpful to the improvement of constipation.
UNASSIGNED: From March 2013 to February 2021, 74 female patients with congenital rectovestibular fistula or rectoperineal fistula were treated. The age of patients ranged from 3 months to 1 year. Barium enema and spinal cord MRI were performed in all children. 4 patients were removed from the study because of spinal cord and sacral agenesis. Finally, 70 patients underwent one-stage anterior sagittal anorectoplasty (ASARP). Anal endoscopy and anorectal pressure measurement were performed 1 year after surgery. All patients were divided into two groups depending on the presence of megarectum (+) and (-) and observed for constipation and anal sphincter function.
UNASSIGNED: 16 patients (4 months to 1 year) were complicated with megarectum, and 5 patients (3 months to 9 months) were without megarectum. The incision infection was seen in 3 patients. All patients were followed up for 1 year to 5 years. Fecal soiling was seen in 2 patients and constipation in 14 patients. Among 16 patients with megarectum, soiling was seen in 1 patient and the constipation in 12 patients. Among 54 patients without megarectum, soiling was seen in 1 patient and constipation in 2 patients. There was a significant difference in the incidence of postoperative constipation between the two groups (megarectum (+) 75% vs. megarectum (-) 3.7% (P < 0.05)). However, there was no significant difference in the score of anal sphincters between the two groups (P < 0.05). And there was no significant difference in anal resting pressure (P = 0.49) and length of anal high pressure area (P = 0.76). 7 patients with constipation and megarectum acquired normal anal function after the dilated rectum was resected.
UNASSIGNED: Megarectum increases the possibility of difficult postoperative defecation in the patients with congenital rectovestibular fistula or rectoperineal fistula. However, constipation was not associated with ASARP postoperative effects on sphincter function. Resection of megarectum is helpful to the improvement of constipation.
摘要：
■评估巨大直肠对先天性直肠前庭瘘或直肠会阴瘘女性患者术后排便的影响。
■从2013年3月至2021年2月，共治疗了74例先天性直肠前庭瘘或直肠会阴瘘的女性患者。患者年龄为3个月至1岁。所有患儿均进行钡灌肠和脊髓MRI检查。由于脊髓和骶骨发育不全，4名患者被从研究中删除。最后,70例患者接受了一期前矢状肛门直肠成形术（ASARP）。术后1年进行肛门内镜检查和肛门直肠压力测量。根据大直肠（）和（-）的存在将所有患者分为两组，并观察便秘和肛门括约肌功能。
■16例（4个月至1年）合并大直肠，5例患者（3个月至9个月）无大直肠。3例患者出现切口感染。所有患者均随访1年至5年。粪便污染2例，便秘14例。在16例大直肠患者中，1例患者出现脏污，12例患者出现便秘。在54名没有大直肠的患者中，1例患者出现脏污，2例患者出现便秘。两组患者术后便秘的发生率有显著差异(大直肠(+)75%vs.大直肠（-）3.7%（P<0.05）。然而,两组患者肛门括约肌评分比较,差异无统计学意义(P>0.05)。肛门静息压(P=0.49)和肛门高压区长度(P=0.76)差异无统计学意义。7例便秘和大直肠患者切除扩张直肠后肛门功能正常。
■巨大直肠增加了先天性直肠前庭瘘或直肠会阴瘘患者术后排便困难的可能性。然而,便秘与ASARP术后对括约肌功能的影响无关。大直肠切除术有助于改善便秘。
■从2013年3月至2021年2月，共治疗了74例先天性直肠前庭瘘或直肠会阴瘘的女性患者。患者年龄为3个月至1岁。所有患儿均进行钡灌肠和脊髓MRI检查。由于脊髓和骶骨发育不全，4名患者被从研究中删除。最后,70例患者接受了一期前矢状肛门直肠成形术（ASARP）。术后1年进行肛门内镜检查和肛门直肠压力测量。根据大直肠（）和（-）的存在将所有患者分为两组，并观察便秘和肛门括约肌功能。
■16例（4个月至1年）合并大直肠，5例患者（3个月至9个月）无大直肠。3例患者出现切口感染。所有患者均随访1年至5年。粪便污染2例，便秘14例。在16例大直肠患者中，1例患者出现脏污，12例患者出现便秘。在54名没有大直肠的患者中，1例患者出现脏污，2例患者出现便秘。两组患者术后便秘的发生率有显著差异(大直肠(+)75%vs.大直肠（-）3.7%（P<0.05）。然而,两组患者肛门括约肌评分比较,差异无统计学意义(P>0.05)。肛门静息压(P=0.49)和肛门高压区长度(P=0.76)差异无统计学意义。7例便秘和大直肠患者切除扩张直肠后肛门功能正常。
■巨大直肠增加了先天性直肠前庭瘘或直肠会阴瘘患者术后排便困难的可能性。然而,便秘与ASARP术后对括约肌功能的影响无关。大直肠切除术有助于改善便秘。
