Delayed presentation of anorectal malformations.
Delayed presentation of anorectal malformations.
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DOI：
10.4103/0971-9261.43023
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发表时间：
2008-04
影响因子：
--
通讯作者：
Tandon RK
中科院分区：
文献类型：
--
作者：
Sinha SK;Kanojia RP;Wakhlu A;Rawat JD;Kureel SN;Tandon RK
肛门直肠畸形（ARM）的延迟处理增加了患者的手术和功能并发症。我们定义了“ARM的延迟表现”，并回顾了我们的ARM患者，以找出延迟表现的发生率和原因。符合“ARM延迟表现”标准的患者也包括在内。从医院记录中获得每位患者的详细信息，包括表现方式、相关异常、治疗计划和随访。2003年至2006年间，43例患者符合我们的“延迟表现”标准。其中男性21人，女性22人。其中17名男性表现为低型ARM。其中11例采用单阶段手术。这些“延迟的演讲者”不得不忍受便秘、体重增加不足和父母焦虑的更长的时间。结果分析显示，以前接受过会阴手术失败的患者有更多的功能并发症。对于低ARM的女性，选择的手术是前矢状肛门直肠成形术（ASARP）。单期手术对大多数低类型ARMs有较好的疗效。男性和女性的高型ARMs采用分阶段处理。“ARM的延迟呈现”是我们设置中ARM的主要组。他们的治疗方法和结果与早期的演讲者没有什么不同。延迟ARM最常见的原因是卫生保健提供者给出的错误建议，其次是其他地方的治疗不充分。会阴部二次矫正手术效果不佳。
Delayed management of anorectal malformation (ARM) increases the surgical and functional complications for the patient. We defined “delayed presentation of ARM” and reviewed our patients with ARM to find out the incidence and causes of delayed presentation. Patients satisfying the criteria of “delayed presentation of ARM” were involved. Detailed information of each patient including the mode of presentation, associated anomalies, plan of management and follow-up was obtained from the hospital records. Between 2003 and 2006, 43 patients satisfied our criteria of “delayed presentation of ARM”. There were 21 males and 22 females. Seventeen of these males presented with low-type ARM. Eleven of them were managed by a single-stage procedure. These “delayed presenters” had to live with constipation, inadequate weight gain and parental anxiety for a greater time. Analysis of the outcomes showed more functional complications in patients who had undergone failed perineal surgery previously. In females with low ARM, the procedure of choice was anterior sagittal anorectoplasty (ASARP). Single stage surgery provides good outcomes for most of low type of ARMs. High-type ARMs in males and females were managed by a staged procedure. “Delayed presentation of ARM” is a major group of ARM in our setup. The management and results of their treatment are not different from those of the early presenters. The most common cause of delayed ARM is wrong advice given by the health care providers followed by inadequate treatment elsewhere. Corrective surgeries taking second attempt in perineum always produces poor outcomes.