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目的探讨改良式Mollard治疗高位肛门直肠畸形的临床价值及疗效评价。方法采用改良Mollard术式即前矢状入路,手术时保留直肠盲袋,剥离盲袋黏膜,切断的近端结肠经直肠盲端肌鞘和耻骨直肠肌,并直视下在会阴前矢状切口将拖下的结肠与肛门外括约肌组成横纹肌复合体行肛门直肠重建。结果术后30例获得随访,随访6个月～3年,临床评分和钡剂灌肠评分优、良率分别是86.67%和83.33%(P>0.05)。结论改良Mollard术式能恢复耻骨直肠肌与肛门外括约肌的解剖关系,将直肠末端从横纹肌复合体中心拖下,随访疗效满意,是治疗高位肛门直肠畸形的一种可选择方法。
Objective To investigate the clinical value and therapeutic effect of modified Mollard in the treatment of high anorectal malformations. Methods The modified Mollard procedure, the anterior sagittal approach, was used to preserve the rectum blind bag, strip the blind bag mucosa, the severed proximal colon via the rectus blind muscle and the puborectalis muscle, and under direct vision in the perineal sagittal Incision will drag down the colon and anal sphincter composed of striated muscle complex anorectal reconstruction. Results 30 cases were followed up for 6 months to 3 years. The clinical scores and barium enema scores were excellent and the rates were 86.67% and 83.33%, respectively (P> 0.05). Conclusion The modified Mollard procedure can restore the anatomic relationship between the puborectalis muscle and the external anal sphincter, drag the distal end of the rectum from the center of striated muscle complex, and follow-up is satisfactory. It is an alternative method for the treatment of high anorectal malformations.