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항문폐쇄증의 병인과 외과적 치료: 132예의 임상분석

Pathogenesis and Treatment of Anal Outlet Obstruction: A clinical analysis of 132 cases

대한대장항문학회지 1997년 13권 1호 p.71 ~ 75
김진천 ( Kim Jin-Chun ) - 울산대학교 의과대학 서울중앙병원 외과학교실 대장항문클리닉

이한일 ( Lee Han-Il ) - 울산대학교 의과대학 외과학교실
박상규 ( Park Sang-Kyu ) - 울산대학교 의과대학 외과학교실
유창식 ( Yu Chang-Sik ) - 울산대학교 의과대학 외과학교실
정희원 ( Jung Hee-Won ) - 울산대학교 의과대학 서울중앙병원 외과학교실

Abstract


Anal outlet obstruction(AOO), which was caused by various anal diseases, presented symptoms like acute or chronic constipation, obstipation, painful defecation and bleeding. We retrospectively reviewed these patients to identify underlying diseases, corresponding surgical treatment and outcome. From July 1989 to December 1995, 132 patients were operated for AOO at Asan Medical Center. Colonic inertia and other pelvic outlet obstructions such as rectocele, rectal intussusception, or Paradoxical puborectalis conraction were excluded from this study by history taking, physical examination, colon
transit time study, manometry, and defecography. Male to female ratio was 1 : 1.2 and mean age was 45 and 44, respectively. Among 132 Patients, 57 cases(43%) had sin91e disease and remained 75 cases had combined two or more diseases. Hemorrhoids(90 cases) was the most common associated disease and then were anal stricture(59 cases),
chronic anal fissure(29 cases), internal sphincter hypertonia(25 cases) and anal fistula(6 cases) in decreasing order. Either single or combined hemorrhoidectomy was performed in 85 cases, lateral internal sphincterotomy in 65 cases, anoplasty in 35 cases, rubber band ligation in 13 cases, manual anal dilatation in 10 cases. Postoperative complications
were 7 cases of wound infection and one case of gas incontinence, that were subsidedby conservative management. 119 patients(90%) showed complete improvement and twelve patients were partially improved from AOO. Only one patient did not respond surgical treatment due to anismus. As AOO is a comprehensive disease entity of frequent anal diseases, adequate surgery for respective patients mandatory to relieve discomfort.

키워드

Anal Outlet
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