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  In children with congenital **** atresia, there is an external **** sphincter in the middle, middle, and low **** atresia. There is no difference and they are well developed. It is equivalent to saying that the development of it is not important, but it is good. The important internal **** sphincter is exactly the opposite. The higher the **** atresia, the worse or even absent its internal **** sphincter.

  Doctor is the most fearful thing about cooking without rice. The text has said this many times.

  In the congenital diseases of children, cooking without rice is a common problem, because most of the deformities of these deformed children are due to the underdevelopment of organs. For example, the esophagus atresia we talked about last time, the worst type, can only go to other organs of the human body to replace the missing esophagus.

Faced with this kind of child, the doctor can only search desperately in the child\'s body, trying to find the residual tissue of the internal **** sphincter. use.

The   Pena procedure does exactly that, using the well-developed external **** sphincter and remnants of the internal rectal sphincter to form a new anus. Its accurate name is posterior sagittal anoplasty. The direction of the scalpel is the same as that of the sphincter, which can avoid damage to the sphincter to the greatest extent, which is the highlight of this operation.

   It can be seen from this that Pena operation is a traditional operation and non-new technology laparoscopy. Families definitely prefer laparoscopy, which is less harmful to the human body. We have talked about this issue in general surgery. There is no advantage in that laparoscopy is difficult to operate in this kind of low-median rectal and **** surgery, so laparoscopy is more used in high-level **** atresia.

   The first step, as Mr. Wu asked, is to determine what position.

   Since Mr. Wu went to inform the operating room, it is conceivable that it is basically impossible to be low. There is usually a fistula in the lower position to defecate, and there is no need to rush the knife. After all, if the operation of such a small child is not life-threatening, the operation itself is too risky.

  Students can\'t answer the teacher\'s question with the teacher\'s behavior, they will be looked down upon by the teacher.

  To accurately determine the location of **** atresia, the most economical solution is to pass abdominal plain film. If the child\'s condition allows, it is more accurate to take an inverted abdominal X-ray, that is, the accompanying person grabs the child\'s feet and the other hand stabilizes the child\'s head or shoulders so that the child is taken upside down.

   Today, this patient only took a simple abdominal plain film, and several classmates carefully judged the plain film around the light board.

This time, it\'s classmate Pan\'s turn to answer this question: "This is the blind end of the inflated rectum, and this may be the pubococcygeus muscle. The two are close to each other and should belong to the median." After saying this, classmate Pan said Look at the other two students first: Do you agree with my opinion?

   "This visual measurement is a bit difficult, is it more than two centimeters?" Lin Hao helped Pan with his eyes, intending to turn them into measuring rulers to measure the distance between the **** and the anus. The textbook said that generally speaking, less than two centimeters is low, and more than two centimeters is medium and high.

   It is more difficult to judge the mid-level and low-level of this part of the film.

   is difficult. Xie added: "It also depends on the child\'s weight and size."

  Some of them seem to be less than two centimeters and should be low. The problem child is less than a month old and is small. Relatively speaking, this less than two centimeters is actually a high distance.

  It is not surprising that there are such inaccurate results.

   (end of this chapter)