PDF(Pubmed)
Abstract：
UNASSIGNED: Complications following posterior sagittal anorectoplasty (PSARP) for ARM are well known. In this article, we present our experience of managing five patients who required major redo surgeries for complications resulting from previous attempts to correct ARM.
UNASSIGNED: We reviewed all patients who underwent major redo surgeries in our hospital for complications from previous repairs for ARM, from June 2013 to June 2019. Data was obtained from hospital records and analysed.
UNASSIGNED: Five patients whose ages ranged from 5 months to 14 years were included in the study. Four were boys and 1 was a girl. All patients had undergone PSARP in other hospitals. The presentations were retained distal bowel causing urinary retention and constipation (n=1), pulled through proximal urethra and bladder neck presenting as passage of urine from neo-anus (n=1), retained common channel (of cloaca) causing a \'H\' type configuration (n=1), mispositioned neo-anus (n=1) following a primary PSARP and lastly undivided recto-urethral fistula causing fecaluria (n=1). All of them underwent redo repairs by posterior sagittal approach with documented improvement in their symptoms. Two of them required total bowel management to remain clean.
UNASSIGNED: All the complications reported here have been described in literature nevertheless, this report will add to the body of experience. Posterior sagittal approach (PSA) has proved to be very successful technique in correcting these complications.
UNASSIGNED: We reviewed all patients who underwent major redo surgeries in our hospital for complications from previous repairs for ARM, from June 2013 to June 2019. Data was obtained from hospital records and analysed.
UNASSIGNED: Five patients whose ages ranged from 5 months to 14 years were included in the study. Four were boys and 1 was a girl. All patients had undergone PSARP in other hospitals. The presentations were retained distal bowel causing urinary retention and constipation (n=1), pulled through proximal urethra and bladder neck presenting as passage of urine from neo-anus (n=1), retained common channel (of cloaca) causing a \'H\' type configuration (n=1), mispositioned neo-anus (n=1) following a primary PSARP and lastly undivided recto-urethral fistula causing fecaluria (n=1). All of them underwent redo repairs by posterior sagittal approach with documented improvement in their symptoms. Two of them required total bowel management to remain clean.
UNASSIGNED: All the complications reported here have been described in literature nevertheless, this report will add to the body of experience. Posterior sagittal approach (PSA) has proved to be very successful technique in correcting these complications.
摘要：
■ARM后矢状肛门直肠成形术（PSARP）后的并发症是众所周知的。在这篇文章中,我们介绍了我们管理5例需要进行大范围重做手术的患者的经验,这些患者以前尝试纠正ARM而导致的并发症.
■我们回顾了所有在我们医院接受过大型重做手术的患者，这些患者的并发症来自之前的ARM修复，2013年6月至2019年6月。从医院记录中获得数据并进行分析。
■5名年龄5个月至14岁的患者被纳入研究。四个是男孩，一个是女孩。所有患者均在其他医院接受了PSARP。表现为肠远端滞留导致尿潴留和便秘（n=1），通过近端尿道和膀胱颈，作为新肛门的尿液通过（n=1），导致\'H\'类型配置(n=1)的保留公共信道(泄殖腔),原发性PSARP术后新肛门错位（n=1），最后是未分裂的直肠尿道瘘，导致尿毒症（n=1）。所有患者均通过后矢状入路进行了重做修复，并记录了症状的改善。其中两个需要全面的肠道管理才能保持清洁。
■这里报道的所有并发症在文献中都有描述，这份报告将增加经验。后矢状入路（PSA）已被证明是纠正这些并发症的非常成功的技术。
■我们回顾了所有在我们医院接受过大型重做手术的患者，这些患者的并发症来自之前的ARM修复，2013年6月至2019年6月。从医院记录中获得数据并进行分析。
■5名年龄5个月至14岁的患者被纳入研究。四个是男孩，一个是女孩。所有患者均在其他医院接受了PSARP。表现为肠远端滞留导致尿潴留和便秘（n=1），通过近端尿道和膀胱颈，作为新肛门的尿液通过（n=1），导致\'H\'类型配置(n=1)的保留公共信道(泄殖腔),原发性PSARP术后新肛门错位（n=1），最后是未分裂的直肠尿道瘘，导致尿毒症（n=1）。所有患者均通过后矢状入路进行了重做修复，并记录了症状的改善。其中两个需要全面的肠道管理才能保持清洁。
■这里报道的所有并发症在文献中都有描述，这份报告将增加经验。后矢状入路（PSA）已被证明是纠正这些并发症的非常成功的技术。
