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本文通过对13例新生儿骶尾部畸胎瘤手术治疗的总结,提出手术时选择“新月形”切口能充分暴露术野,缝合后切口远离肛门防止粪便污染以及放置引流可有效预防切口感染。切除尾骨,彻底切除肿瘤组织是防止肿瘤复发的关键。骶前肿块过大时应作腹部联合切口不可勉强经骶尾部手术,以防肿瘤切除不彻底或导致副损伤。手术中应注意保护臀肌及其血管神经,防止直肠损伤,强调在肛门周围不能作大块组织切除以免损伤肛门外括约肌,如有损伤应仔细修补。强调重建肛尾韧带,使其与骶骨、直肠妥善固定,可防止盆底松弛和盆腔器官下垂。
This article summarizes the surgical treatment of 13 cases of neonatal teratoma of the sacrococcygeal sulcus. It is proposed that the “crescent” incision can fully expose the operative field. After the suture, the incision is far away from the anus to prevent fecal contamination and placement drainage can effectively prevent incision infection. Removal of the coccyx and complete removal of the tumor tissue are the key to prevent tumor recurrence. If the anterior mass is too large, a combined abdomen incision should be made to ensure that the tumor is not completely removed or the accessory injury is caused. Surgery should pay attention to protect the gluteus and its vascular nerves to prevent rectal injury, emphasizing that can not be made around the anus to remove large chunks of tissue so as not to damage the external anal sphincter, if any damage should be carefully repaired. Emphasis on reconstruction of the anal ligament to properly fix it with the sacrum and rectum prevents pelvic floor sagging and pelvic organ sagging.