FIELD: medicine.
SUBSTANCE: invention relates to medicine, in particular to surgery and can be used for treatment of patients with paradoxical encopresis. If there are no arterial bypasses according to data of selective angiography of inferior mesenteric artery basin and inefficient conservative therapy operative intrusion is carried out. For this purpose through posterior-sagittal access enucleating of two coccygeal vertebras with preservation of periosteum is performed. After that plication of widened rectal ampula is performed with two longitudinal sutures in form of Latin letter V with angle of 30 degrees. Further, muscles of outer sphincter are pulled backwards and upwards. Muscles of outer sphincter are sutured to preserved periosteum of enucleating coccygeal vertebras. In post-operation period therapy with selective α1-adrenocepter antagonists in therapeutic dose during 2 months.
EFFECT: method is low-traumatic, allows to reduce risk of complications development in post-operation period and disease recurrence by improvement of healinbg of outer sphincter muscular fibres due to preservation of periosteum of coccygeal vertebras, ensures prophylaxis of coccygodynia, allows to form rectum more anatomically, to obtain improvement of rectum blood supply and recovery of injured intramural nerve endings of rectum, has normalising and coordinating effect in system "inner sphincter -rectum - pelvic floor".
1 ex, 1 dwg
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Authors
Dates
2009-09-27—Published
2008-09-09—Filed