6肛门直肠畸形大课2014精编.ppt

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Operative procedures Perineal operation Anterior sagittal approach Sacroperineal procedure PSARP Abdominosacroperineal pull-through Abdominoperineal pull-through Laparoscopic-assisted pull-through International grouping of surgical procedures (Krickenbeck, 2005) Anal dilatation Two weeks after surgery, anal dilatations should be performed to ensure the anal opening is large enough to allow normal passage of stool Anal dilatations should continue for six months to prevent recurrent anal stenosis and scarring Postoperative Care Anal stenosis Prolapse of the rectal mucosa Fecal incontinence Fistula recurrence Constipation Postoperative Complications Key point Rectoanal Angle/Striated Muscle Complex Classification of imperforate anus PC line Clinical presentations Surgical principal PSARP If you want to learn English your best option for success is to employ a teacher whose first language is English Thank you * Good afternoon colleagues. First of all, I have to thank the society for inviting us today and also my division chief, Professor Paul Tam, to let me give a talk here. I realise that most of you are not surgeons, so I will try to make the technical side of the talk as simple as possible. * * * * * * * * * * * * * * * * line of demarcation * * * * * * * * * * Persistent cloaca Pathological changes are very complicated Sphincter muscle Never Sacrum Associated anomalies The higher the defect, the severer the pathological change, the less the likelihood will be of achieving bowel control Pathology VACTERL Association VACTERL V vertebral A Anorectal C Cardiac T Tracheo-esophageal fistula E Esophageal atresia R Renal L Limb Associated Anomalies Cardiovascular Gastrointestinal Spinal and vertebral Genitourinary Gynecologic Symptoms are variable Different type : different Symptoms The level of distal pouch With or without fistula Size and position of the fistula Associated anomal