非観血的圧挫法による直腸閉鎖症の1治験例

概要

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Rectal atresia with a normal anus is a rare anomaly in ano-rectal malformations. A 8 month old boy was treated successfully by non-suture method using a newly developed instrument and a colonofiberscope. This instrument is set up of a supporting bar, a pair of rings and a spring. At his newborn period, a left transeverse colostomy was made for decompression and further investigations of rectal blind pouch. The details of this procedure are summarrized as follows ; 1) insert a nylon thread into rectal blind pouch from anal side penetrating the atretic region 2) pick up the thread by forceps under a direct vision through colonofiberscope resulting in a passing of the thread from anus to distal orifice of colostomy 3) place a proximal part of the instrument in rectal blind pouch by using the nylon thread 4) place a distal part of the instrument including a spring in anal blind pouch and accomplish the compression of an atretic regin. Preoperative careful examinations are recommended to avoid the damage to puborectal muscle which is important for a continence. Distance between two blind pouches and position of blind pouches in relation to a puborectal muscle should de precisely evaluated. If indication is exactly selected, this procedure is useful because of it's simplicity.
日本小児外科学会の論文
1986-05-20