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탈직장의 경항문 직장후벽 성형술

Transanal Posterior Anorectoplasty of Rectal Prolapse

대한대장항문학회지 2002년 18권 5호 p.269 ~ 273
김종덕 ( Kim Jong-Duck ) - 부산대학교 의과대학 외과학교실

예병국 ( Yea Byung-Kook ) - 부산대학교 의과대학 외과학교실
조홍재 ( Jo Hong-Jae ) - 부산대학교 의과대학 외과학교실
오남건 ( Oh Nahm-Gun ) - 부산대학교 의과대학 외과학교실

Abstract


Purpose: Many different procedures for rectal prolapse have been described, but optional surgical treatment remains controversial. The aim of this report is to introduce an innovative and effective method of surgical treatment to restore anal continence and anatomic correction of rectal prolapse.

Methods: Data were retrospectively collected and analyzed on 11 patients (7 male and 4 female) who underwent transanal posterior anorectoplasty for complete rectal prolapse between Jan. 1995 to Dec. 2000. This procedure is summarized to five steps as follows: 1. Partial resection of posterior rectal ampulla. 2. Longitudinal plication with posterior fixation. 3. Posterior levatorplasty. 4. One layer suture as longitudinal fashion. 5. Gant-Miwa operation-like procedure on anterior rectum.

Results: There were no cases of postoperative infection and bleeding. There were no cases of recurrence of the rectal prolapse except 1 case of ant. mucosal prolapse which was successfully treated with one more Gant-Miwa operation-like procedure at postoperative 3 months. Fecal incontinence were in two cases at postoperative 12 months which were estimated as grade 2 by assessment of bowel function by Kirwan.

Conclusions: Although, the best operation for rectal prolapse remains controversial subject, authors believe that transanal posterior anorectoplasty should be considered as effective new surgical procedure for the treatment of rectal
prolapse.

키워드

탈직장;경항문 직장후벽 성형술
Rectal prolapse;Transanal posterior anorectoplasty;Levatorplasty
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