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首页> 外文期刊>Surgical Endoscopy >Earlier appearance and higher incidence of the rectoanal relaxation reflex in patients with imperforate anus repaired with laparoscopically assisted anorectoplasty.
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Earlier appearance and higher incidence of the rectoanal relaxation reflex in patients with imperforate anus repaired with laparoscopically assisted anorectoplasty.

机译：腹腔镜辅助肛门直肠成形术修复的无孔肛门患者的早期出现和直肠松弛反应的发生率较高。

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Background: This study aimed to evaluate clinically and manometrically the anorectal function of patients with imperforate anus after repair with laparoscopically assisted anorectoplasty (LAR), as compared with the function of patients after undergoing the conventional method, posterior sagittal anorectoplasty (PSARP). Methods: The defecation status and anorectal manometry of patients with high or intermediate type imperforate anus repaired with LAR ( n = 9) and age-matched patients repaired with PSARP ( n = 13) were assessed and compared during the first year of postoperative follow-up evaluation. The defecation status was classified by the frequency of bowel openings (<1, 1-4, and >5 times per day). Manometric assessment was performed by an open-tip hydraulic capillary infusion system. The presence of the rectoanal relaxation reflex was determined, and the resting sphincteric pressure and resting rectal pressure were measured. Results: Seven of nine LAR patients had an acceptable to 7 of 13 PSARP patients. The difference in the presentation of daily stooling is not significant ( p > 0.05). A positive RAR was detected in 88.9% (8/9) of the LAR patients, and in only 30.8% (4/13) of the PSARP patients ( p < 0.01). The presence of a rectoanal relaxation reflex also significantly correlated with an acceptable frequency of bowel opening (1-4 times per day) in both LAR and PSARP patients ( p < 0.05). Moreover, a rectoanal relaxation reflex was detected significantly earlier in LAR than in PSARP patients (4.9 +/- 1.2 vs 10.1 +/- 2.5 months; postoperatively p < 0.0001). Both the LAR and PSARP patients had a similar resting sphincteric pressure (21.5 +/- 4.7 vs 25.4 +/- 6.2 cm H(2)O; p > 0.05). By contrast, the resting rectal pressure was significantly lower in LAR than in PSARP patients (7.7 +/- 1.5 vs 11.5 +/- 1.3 cmH(2)O; p < 0.05). Conclusions: In the early postoperative stage, patients repaired with LAR had more favorable findings in anorectal manometry than patients repaired with PSARP. Long-term follow-up studies to confirm a superior defecation continence achieved with LAR are warranted.
机译：背景：本研究旨在通过腹腔镜辅助肛门直肠成形术（LAR）修复后无孔肛门患者的肛门直肠功能与常规方法后矢状后肛门肛门成形术（PSARP）相比，评估其肛门直肠功能。方法：在术后随访的第一年中，评估并比较了LAR修复的高或中型无孔肛门患者（n = 9）和年龄匹配的PSARP修复（n = 13）患者的排便状态和肛门直肠压力。评价。排便状态按肠开放频率分类（每天<1、1-4和> 5次）。通过开放式液压毛细管输注系统进行测压评估。确定直肠松弛反应的存在，并测量静息括约肌压力和静息直肠压力。结果：9名LAR患者中有7名接受了13名PSARP患者中的7名。日常便便的表现差异不显着（p> 0.05）。 LAR患者的RAR阳性率为88.9％（8/9），而PSARP患者的RAR阳性率为30.8％（4/13）（p <0.01）。直肠肛门松弛反射的存在也与LAR和PSARP患者的可接受的肠开放频率（每天1-4次）显着相关（p <0.05）。此外，在LAR中，比PSARP患者更早发现了直肠的肛门反射（4.9 +/- 1.2 vs 10.1 +/- 2.5个月;术后p <0.0001）。 LAR和PSARP患者的静息括约肌压力相似（21.5 +/- 4.7 vs 25.4 +/- 6.2 cm H（2）O; p> 0.05）。相比之下，LAR的静息直肠压力显着低于PSARP患者（7.7 +/- 1.5 vs 11.5 +/- 1.3 cmH（2）O; p <0.05）。结论：在术后早期，LAR修复的患者在肛门直肠测压方面比PSARP修复的患者具有更好的发现。有必要进行长期随访研究，以确认使用LAR可以达到较高的排便率。

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