鎖肛術後の高度粘膜脱に対する全周 sliding skin graft 法

概要

論文の詳細を見る
Prolapse of the excessive rectal mucosa is one of the most common complications following rectoplasty for anorectal malformation in children. In such cases, a sliding skin graft as described by Carmel has added much to the improvement of results. In annular prolapse of the rectal mucosa, however, the sliding skin graft is either impractical or impossible in order to remove all of the pathologic condition and restore an anatomically correct anus. In six such exceptional patients, we have successfully used a circumferential sliding skin graft without any complication except for occasional scar formation. Use of circumferential sliding skin graft is a simple technique as follows. After removal of all pathologic condition, Whitehead's rectoplasty is done and four Carmel's sliding skin grafts are employed surrounding the restored anus. Because of the sequellae such as scar formation, this operation is, however, not recommeded as routine for annular prolapse of the rectal mucosa. The patients, in whom the mucocutaneous suture line moves into full depth of the anal canal at Whitehead's procedure, may be contraindicated for this operation.