內視鏡輔助經肛門直腸肛門吻合術治療直腸閉鎖：一病例報告

Endoscopic-assisted of transanal rectoanal anastomosis for the treatment of rectal Atresia: A Case Report

直腸閉鎖是肛門直腸畸形的一種罕見亞型，患者出生時肛門外觀正常，但在直腸齒狀線近端距離2-3厘米處是完全的閉鎖。我們介紹一例使用內視鏡輔助的經肛門端對端直腸吻合術作為治療直腸閉鎖的新手術技術。一位男性新生兒出生時經身體檢查及X光檢查，診斷為直腸閉鎖。並且換患者先接受暫時性大腸造口術。在6個月大時接受利用内視鏡輔助經由肛門的方法來實施直腸重建術。手術兩週之後再實施大腸造口關閉及直腸吻合處手術。術後每天進行直腸擴張以避免狹窄達到最好的治療方式及預後。
結論，利用内視鏡輔助經肛門來冶療肛門閉鎖是可以考慮手術的方式之一。

Rectal atresia is a rare subtype of anorectal malformations in which the patients are born with a normal anal canal but have complete atresia located few centimeters proximal to the dentate line. We present one case using endoscopic-assisted the transanal recto-anal anastomosis as a new surgical technique for the management of rectal atresia. A male born with rectal atresia was diagnosed during physical examination and confirmed with X-ray. The anatomic appearance of the external anus, and perineum were normal. An X-ray of the abdomen showed a blind ending dilated intestine, 2.76 cm from rectum. A colostomy was performed. At the age of 6 months, a operation was carried out by using endoscopic assisted transanal recto-anal anastomosis surgical technique. Two weeks later, the colostomy was closed. The rectal anastomosis was treated with rectal dilatation daily in order to avoid stricture. In conclusion, the endoscopic assisted and transanal approach is an alternative to other surgical techniques in the management of rectal atresia.