Hem-o-10k在腹腔镜肛门成形术中的应用

目的探讨Hem-o—lok在腹腔镜肛门成形术处理直肠尿道瘘中的价值。方法2012年1月～2013年12月采用腹腔镜治疗15例中高位肛门闭锁，在距球部、膜部或膀胱颈部尿道0．5cm处应用Hem—o—lok夹闭瘘管处理直肠尿道瘘。结果均在腹腔镜辅助下完成肛门成形＋尿道瘘修补术，腹腔镜手术（包括会阴手术）操作时间90～150min（平均120rain）。出血量10～20ml（平均15m1），无需要输血者，无术中并发症发生。术后7d拔除尿管，无排尿困难。15例随访2～12个月（平均5个月），术后排尿功能基本正常，无尿道瘘复发，无尿道狭窄发生，肛门外观正常，2例患儿轻度直肠黏膜脱垂。结论腹腔镜辅助下Hem-o-lok夹闭处理直肠尿道瘘，更加精准、方便，降低手术难度，可取得满意的治疗效果。

Application of Hem-o-lok in Laparoscopic Assisted Anorectal Pull-through

Objective To evaluate the application of the Hem-o-lok for the treatment of rectal urethral fistula in laparoscopic assisted anorectal pull-through. Methods Fifteen patients with high imperforate anus were retrospectively reviewed in our hospital from January 2012 to December 2013. The rectal urethra fistula was shut by the Hem-o-lok at the O. 5 em from the end of the fistula. Results All the patients were successfully treated by laparoscopic assisted anorectal pull-through with fistula repair. The operative time ranged 90 - 150 min （median, 120 min）. The mean blood loss was 15 ml （range, 10 -20 ml） during the operation and no blood transfusion was required. All the patients had no intraoperative complications. The mean follow-up time was 5 months （range, 2 - 12 months）. There was no patient suffered from recurrent fistula. The appearance of the neo-anus was normal. Two patients suffered from slight mucosa prolapse. Conclusion The application of the Hem-o-lok for the treatment of rectal urethral fistula in laparoscopic assisted anorectal pull-through is accurate, convenient, and time saving, achieving satisfactory results.