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目的介绍自制肛门环状拉钩在小儿后天性直肠前庭瘘经肛修补术的应用经验。方法小儿直肠前庭瘘23例(其中直肠舟状窝瘘18例、直肠阴唇瘘4例、直肠阴道瘘1例),年龄6月～13岁,扩肛后肛门一周缝6～8根牵引线缝合固定于自制肛门环状拉钩上,可充分显露肛管及瘘内口,横梭形切开瘘口黏膜,切除瘘口内黏膜及瘢痕组织,缝闭瘘道,扇形游离瘘口近端黏膜与瘘口远端黏膜对位缝合。结果一期治愈19例,1例术后复发,3例失访,平均出院时间为术后3.5d,随访无肛门狭窄、大便失禁,效果良好。结论应用自制肛门环状拉钩可明显增加肛管、直肠显露,提高疗效。
Objective To introduce the application experience of homemade anal ring-shaped pull hook in the repair of children’s acquired rectal vestibulo-fistula by anal repair. Methods Twenty-three cases of pediatric rectocele fistula (including 18 cases of rectal boat-shaped fistula, 4 cases of rectovaginal fistula and 1 case of rectovaginal fistula), aged 6 months to 13 years old, Fixed on the self-made anal ring hook, the anal canal and fistula can be fully exposed, transverse fusiform mucosa, resection of mucosa and scar tissue, fistula, fissure near the mucosa and fistula Oral distal mucosal suture. Results The first stage was cured in 19 cases, one case was recurrent and the other 3 cases were lost. The average discharge time was 3.5 days after operation. No anal stenosis and incontinence were observed, and the effect was good. Conclusion The use of self-made anal ring hook can significantly increase the anal canal, rectal exposure, improve the curative effect.