先天性肛门直肠畸形治疗近况

先天性肛门直肠畸形是指胚胎后肠末端发育异常的一类疾病的总称,是小儿常见的消化道畸形,据国内畸形监测网统计,我国的发生率为2.81/万.近年来人们对直肠肛门畸形的病理改变和肛门排便控制的生理与病理进行了深入的研究,随着腹腔镜手术器械的创新和改进,使该手术方法 得到不断地完善.     

先天性巨输尿管症25例

目的：探讨先天性巨输尿管症的诊治方法。方法：报告25例先天性巨输尿管症，其中左侧13例，右侧10例，双侧2例。25例中行肾输尿管切除术6例，行输尿管膀胱吻合术12例。结果：12例输尿管膀胱吻合术均成功。结论：儿童患应尽早手术治疗，成人患可根据病变采用保守或手术治疗。治疗本症的原则是解除梗阻，尽量保留肾功能。理想的手术方式是输尿管裁剪加输尿管膀胱吻合术。     

Carcinoid tumours of the rectum and anus

Carcinoid tumours of the anorectum comprise only 0.1 per cent of all rectal tumours. Their behaviour and treatment are still debatable. We identified 35 cases from the records of St Mark's Hospital; 31 were benign and 4 were malignant. Benign tumours were of three distinct histopathological patterns. All benign tumours were cured by local treatment. Malignant tumours can be identified clinically; the only consistent microscopic feature was invasion of the muscularis propria. All patients with malignant tumours died, despite radical surgical treatment; lymph node metastases were invariably present in the operation specimens. Because radical treatment for malignant carcinoid tumours of the anorectum is largely unsuccessful, a flexible surgical approach is advocated.     

Congenital urethral fistula with normal anus: a report of two cases.

Congenital rectourethral or anourethral fistulae without imperforate anus in males are rare, representing less than 1% of anorectal malformations. We report our experience with two males with "N type" urethral fistulae. One, a 5-year-old boy, presented with recurrent urinary tract infections (UTIs) and passage of urine per anus. Investigations included a voiding cystourethrogram (VCUG), which demonstrated a fistula from the urethra to the anus. On physical examination, a small perianal opening was noted just outside the anus, which drained a small amount of urine after voiding. The fistula was excised via a perineal approach. The second patient is a 5-year-old boy with a long history of recurrent UTI requiring multiple hospitalizations since the newborn period. Chronic renal failure developed as a complication of repeated urinary tract infections. Investigations showed a single hydronephrotic pelvic kidney and a small bladder. He underwent numerous diagnostic and reconstructive procedures including cystoscopy and augmentation cystoplasty. Recurrent infections continued and an N type anourethral fistula was eventually diagnosed. The fistula was located between the anal canal and the membranous urethra. An anterior perineal approach was also used. Both fistulae were easily located, and reconstructive surgery of the urethra was not required. Postoperative VCUGs in both patients were normal. They have been free of infection with normal urinary continence since resection of the fistula. Congenital N type anourethral fistulae are rare, but should be considered in cases of recurrent urinary tract infections. The diagnosis may be missed by endoscopic procedures, but VCUG should demonstrate the fistulous tract.     

慢性前列腺炎经肛门直肠电热治疗──附137例报告

报告作者研制的经肛门直肠电热与经直肠给药相结合的８９０１型前列腺炎治疗仪，在动物实验的基础上，对１３７例慢性前列腺炎进行治疗。经２周治疗后，休息１周再行前列腺按摩液复查，结合自觉症状消失或改善情况判断治疗效果。结果治愈４７例，好转７８例，无效１１例，总有效率达９１．２％。