先天性肛门直肠畸形术后直肠黏膜脱垂的病因分析

侯金凤; 侯金平; 李晓庆; 王佚

doi:10.16016/j.1000-5404.201707073

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先天性肛门直肠畸形术后直肠黏膜脱垂的病因分析

临床医学 | 更新时间：2026-01-09

- 先天性肛门直肠畸形术后直肠黏膜脱垂的病因分析
- Etiological analysis of postoperative rectal mucosal prolapse in children after congenital anorectal malformation surgery
- 第三军医大学学报 2017年39卷第23期页码：2312-2315
- 作者机构：
  
  400014 重庆，重庆医科大学附属儿童医院胃肠新生儿外科，儿童发育疾病研究省部共建教育部重点实验室，重庆市儿童发育重大疾病诊治与预防国际科技合作基地，重庆市儿科学重点实验室
- 作者简介：
  
  [王佚，E-mail:wy757311@hotmail.com WANG Yi, E-mail: wy757311@hotmail.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201707073
  中图分类号： R619;R726.571
- 收稿：2017-07-10，
  
  修回：2017-09-22，
  
  纸质出版：2017-12-15
- 稿件说明：
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侯金凤, 侯金平, 李晓庆, 等. 先天性肛门直肠畸形术后直肠黏膜脱垂的病因分析[J]. 第三军医大学学报, 2017,39(23):2312-2315.

Jinfeng HOU, Jinping HOU, Xiaoqing LI, et al. Etiological analysis of postoperative rectal mucosal prolapse in children after congenital anorectal malformation surgery[J]. Journal of Third Military Medical University, 2017, 39(23): 2312-2315.
侯金凤, 侯金平, 李晓庆, 等. 先天性肛门直肠畸形术后直肠黏膜脱垂的病因分析[J]. 第三军医大学学报, 2017,39(23):2312-2315. DOI： 10.16016/j.1000-5404.201707073.

Jinfeng HOU, Jinping HOU, Xiaoqing LI, et al. Etiological analysis of postoperative rectal mucosal prolapse in children after congenital anorectal malformation surgery[J]. Journal of Third Military Medical University, 2017, 39(23): 2312-2315. DOI： 10.16016/j.1000-5404.201707073.

摘要

目的

分析并总结先天性肛门直肠畸形(anorectal malformations

ARMs)术后患儿直肠黏膜脱垂的发生情况及影响因素。

方法

回顾性分析我院2014－2016年收治的354例先天性肛门直肠畸形患儿的病历资料，分析总结各种类型ARMs术后直肠黏膜脱垂的情况及影响因素。

结果

① 354例ARMs患儿行经会阴或(腹)骶会阴肛门成形术，术后15例(4.24%)出现直肠黏膜脱垂。②无肛伴直肠舟状窝瘘、中位及高位ARMs术后直肠黏膜脱垂发生率经χ

检验差异有统计学意义(

0.05)；122例经(腹)骶会阴肛门成型术患儿，男性80例，女性42例，骶尾部畸形组23例，无畸形组99例，脊髓栓系组5例，无脊髓栓系组117例，3组分别经χ

检验，直肠黏膜脱垂发生率差异均无统计学意义(

0.05)；脱垂组骶尾比值为0.671±0.101，未脱垂组骶尾比值为0.678±0.085，两者经

检验差异无统计学意义(

0.05)。

结论

先天性肛门直肠畸形术后直肠黏膜脱垂发生率不高，与直肠盲端的位置高低有关，闭锁盲端位置越高术后越容易出现直肠黏膜脱垂；与手术方式的选择有关，与性别、是否合并骶尾部畸形及脊髓栓系无关，与骶尾比值的高低无关。

Abstract

Objective

To analyze and summarize the occurrence and influence factors of postoperative rectal mucosal prolapse in children after anorectal malformation (ARM) surgery.

Methods

A retrospective study was carried out on 354 ARM children who undergoing surgical treatment in our department from 2014 to 2016. The occurrence and influencing factors of postoperative rectal mucosal prolapse in various types of ARMs were analyzed.

Results

① Among the 354 ARM patients undergoing perineal anorectoplasty or posterior sagittal (abdominal) anorectoplasty (PSARP)

rectal mucosa prolapse occurred in 15 cases (4.24%). ②There were significant differences in the incidence of rectal mucosa prolapse in the children with rectovestibular fistula

mid-and high-ARM (

0.05). There were 122 children (80 males and 42 females) undergoing PSARP

including 23 cases with sacral tail deformity and the other 99 without such deformity

and 5 cases with tethered cord syndrome and the left 117 cases without. No obvious difference was seen in the incidence between the male and female

those with sacral tail deformity and not

and those with tethered cord syndrome and not (

0.05). The average quality of the sacrum was 0.671±0.101 in the prolapse group and 0.678±0.085 in the non-prolapse group

and no difference was seen between the 2 groups (

0.05).

Conclusions

The incidence of rectal mucosal prolapse is quite low in children after ARM surgery. Its incidence is related to the location of blind rectal end

with the position higher

more prone to rectal mucosal prolapse. What's more

the occurrence is also associated with surgical approaches

but not with sex

sacral tail deformity

tethered cord syndrome or quality of the sacrum.

关键词

Keywords

references

蔡威.小儿外科学[M]. 5版.北京:人民卫生出版社, 2014:348.

CAI W. Pediatric surgery[M]. 5th ed. Beijing: People's Medical Publishing House, 2014:348.

王果.小儿外科手术学[M]. 2版.北京:人民卫生出版社, 2010:405.

WANG G. Pediatric operative surgery[M]. 2nd ed. Beijing: People's Medical Publishing House, 2010:405.

JUNG S M, LEE S K, SEO J M. Experience with laparoscopic-assisted anorectal pull-through in 25 males with anorectal malformation and rectourethral or rectovesical fistulae: postoperative complications and functional results[J]. J Pediatr Surg, 2013, 48(3): 591-596. DOI:10.1016/j.jpedsurg.2012.08.001.

BISCHOFF A, PEÑA A, LEVITT M A. Laparoscopic-assisted PSARP -the advantages of combining both techniques for the treatment of anorectal malformations with recto-bladderneck or high prostatic fistulas[J]. J Pediatr Surg, 2013, 48(2): 367-371. DOI:10.1016/j.jpedsurg.2012.11.019.

HAN Y, XIA Z, GUO S, et al . Laparoscopically assisted anorectal pull-through versus posterior sagittal anorectoplasty for high and intermediate anorectal malformations: a systematic review and meta-analysis[J ] . PLoS One, 2017, 12(1): e0170421. DOI:10.1371/journal.pone.0170421.

LEUNG J L, CHUNG P H, TAM P K, et al . Application of anchoring stitch prevents rectal prolapse in laparoscopic assisted anorectal pullthrough[J ] . J Pediatr Surg, 2016, 51(12): 2113-2116. DOI:10.1016/j.jpedsurg.2016.09.051.

黄寿奖, 秦琪, 吕成杰.腹腔镜下肛门成形术治疗直肠肛门畸形的并发症分析[J].中华小儿外科杂志, 2017, 38(1):51-54.DOI: 10.3760/cma.j.issn.0253-3006.2017.01.012.

HUANG S J, QIN Q, LYU C J. Postoperative complications of laparoscopic assisted anorectal pull-through in children with congenital anorectal malformations[J]. Chin J Pediatr Surg, 2017, 38(1):51-54. DOI: 10.3760/cma.j.issn.0253-3006.2017.01.012.

BRISIGHELLI G, DI CESARE A, MORANDI A, et al . Classification and management of rectal prolapse after anorectoplasty for anorectal malformations[J ] . Pediatr Surg Int, 2014, 30(8): 783-789. D OI:10.1007/s00383-014-3533-7.

郑珊, 张培, 董岿然.先天性肛门直肠畸形肛门成形术后再手术的临床分析[J].中华小儿外科杂志, 2012, 33(4): 296-299. DOI: 10.3760/cma.j.issn.0253-3006.2012.04.014.

ZHENG S, ZHANG P, DONG K R. Retrospective study of reoperation for congenital anorectal malformation [J]. Chin J Pediatr Surg, 2012, 33(4):296-299.DOI: 10.3760/cma.j.issn.0253-3006.2012.04.014.

何小兵, 容文星. 76例肛门成形术后直肠黏膜脱垂的治疗及疗效分析[J].广州医药, 1996, 27(3): 24-25.

He X B, Rong W X. Treatment method and efficacy analysis of 76 cases rectal mucosa prolapse after anoplasty[J]. Guangzhou Med J, 1996, (03):24-25.

BELIZON A, LEVITT M, SHOSHANY G, et al . Rectal prolapse following posterior sagittal anorectoplasty for anorectal malformations[J ] . J Pediatr Surg, 2005, 40(1): 192-196. DOI:10.1016/j.jpedsurg.2004.09.035.

郑珊, 黄炎磊, 肖现民.改良后矢状入路骶会阴肛门成形术Ⅰ期根治新生儿中高位肛门直肠畸形[J].中华小儿外科杂志, 2008, 29(4):216-219.DOI: 10.3760/cma.j.issn.0253-3006.2008.04.007.

ZHENG S, HUANG Y L, XIAO X M. One-stage correction of intermediate imperforate anus with modified posterior sagittal anorectoplasty[J]. Chin J Pediatr Surg, 2008, 29(4):216-219.DOI: 10.3760/cma.j.issn.0253-3006.2008.04.007.

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