"上顶下拖"法治疗中间位肛门闭锁

目的设计一种新的手术方法“上顶下拖”法，用于治疗中间位肛门闭锁。方法经腹于直肠内置—宫颈扩张器从上向下顶出直肠盲袋，会阴部游离并拖出直肠盲袋行肛门成形术。1990年至2003年用该法完成中间位肛门闭锁手术32例。结果32例全部成活。4例术后肛门狭窄、排便困难，经强力扩肛半年治愈，无明显肛门失禁病例。结论“上顶下拖”法治疗中间位肛门闭锁，手术操作简便、安全，术后肛门功能满意。

Push Up Ward and Pull Down Out to Treat Interposition Anal Atresia

Objective We designed a new operative approach named as push upward and pull down out for treating anal atresia of interposition. Methods Caecum of rectum was pushed down out by a cervical canal dilator inserted from abdomen incision, striped and pulled out from perineal incision and then was sutured with skin of perineum. 32 cases of interposition anal atresia had been treated through this operation approach from 1990 to 2003. Results All 32 cases were survived. 4 cases had sequela of anal stenosis and difficult defecation and all were healed by forced anal dilation through half-a-year. No fecal incontinence was happened. Conclusion The 'push up ward and pull down out approach is a simple and safe operation for anal atresia of interposition and can obtain satisfactory anal function.