OONOENITAL MALFORMATIONS OF THE RECTUM AND ANUS.
Separate Development of Rectum and Anus. — Narrowing of the Anus or Rec- tum without Complete Occlusion. — Congenital Stricture. — Closure of the Anus by a Membranous Diaphragm. — Entire Absence of the Anus, the Rec- tum Binding in a Blind Pouch at a Point more or Less Distant from the Perineum — ^Rectum Same as in Last Variety and the Anus NormaL — Anus Absent and Rectum Opening by an Abnormal Anus at Some Point in the Perineal or Sacral Regions. — Cases. — ^Anus Absent and Rectum Ending in the Bladder, Urethra, or Vagina. — Cases. — ^Rectum and Anns Normal, but Ureters, Uterus, or Vagina Empty into Rectum. — ^Total Ab- sence of Rectum. — ^Absence of Lazge Intestine. — Obliteration from Intra- uterine Disease. — Treatment. — Operation Should Always be Performed and Without Delay.— Attempt Should First be Made to Establish an Anus <Callout type="important" title="Important">in the Anal Region.</Callout> PAGB VI CONTENTS.
Measurements of Pelvis at Birth. — IJse of Trocar not Justifiable. — Useful Anus Seldom Obtained by Means of Incision Alone. — Objections to Cutting Operation Without Plastic Operation. — Proctoplasty. <Callout type="tip" title="Tip">If Attempt to Establish New Anus in Anal Region Fail, Colotomy at Once to be Performed.</Callout> Inguinal Preferable to Lumbar Colotomy. — History of Colotomy.— Callisen. — Amussat. Description of Operation of Colotomy. <Callout type="risk" title="Risk">Dangers of Operation.</Callout> — The Inguinal Operation. Description. Attempts at Establishing Anus in Anal Region after Colotomy Generally Unsuccessful. Cases. Closure of Artificial Anus. Operation of Dupuytren. <Callout type="modification" title="Modification">Modifications of Dupuytren's Operation</Callout>.
Key Takeaways
- Operations should be performed without delay to treat congenital rectal and anorectal malformations.
- Attempting to establish a new anus in the anal region before performing colotomy can be ineffective.
- Colotomy, particularly the inguinal approach, is often necessary when attempts at establishing a new anus fail.
Practical Tips
- Always seek professional medical advice and treatment for congenital rectal and anorectal malformations as soon as possible.
- Understand that surgical interventions can be complex and may require multiple steps or modifications to achieve the desired outcome.
- Be prepared for potential complications during and after surgery, including the need for additional procedures.
Warnings & Risks
- The use of a trocar is not recommended as it often fails to produce a useful anus.
- Relying solely on incision without plastic operation can lead to ineffective results.
- Colotomy carries significant risks and should be performed by experienced surgeons only.
Modern Application
While the surgical techniques described in this chapter are historical, they provide valuable insights into the treatment of congenital rectal and anorectal malformations. Modern medicine has advanced significantly, offering more precise diagnostic tools and improved surgical methods. However, understanding these early approaches can help in recognizing the importance of timely intervention and the complexity of such conditions.
Frequently Asked Questions
Q: What is the recommended approach if attempts to establish a new anus fail?
If attempts to establish a new anus in the anal region fail, colotomy should be performed immediately. The inguinal approach is preferable to the lumbar method due to its lower risk and better outcomes.
Q: Why is the use of a trocar not justifiable according to this chapter?
The use of a trocar is not recommended as it often fails to produce a useful anus, making it an ineffective surgical approach for treating congenital rectal and anorectal malformations.
Q: What are the potential risks associated with colotomy surgery?
Colotomy can be dangerous and should only be performed by experienced surgeons. The chapter mentions that attempts at establishing a new anus in the anal region after colotomy are generally unsuccessful, highlighting the significant risks involved.