本文经过40具新生儿尸体解剖及模拟试验研究,证明直肠壁外贴附性纤维层能够限制直肠弹性,保持直肠硬筒状形态,限制直肠容积长度,维持并传导直肠内压力.这些功能对排便反射及粪便形态与排出均很重要.手术中切断此直肠壁贴附性纤维层可使直肠原长度平均增长102.2%,有利于尾路直肠拖出术的成功.%A layer of fibers adherent to the rectal wall was found by Dr.zhang J.Z.in 1976 during sacral anoplasty.The rectal stump can be lengthened for about double of its original length by dividing those perirectal fibers which limit the free elasticity of the rectal wall.By this way,most of the middle or high Ievel anormalies can be successfully treated by sacral approach.Colleagues including Chinese and overseas followed this way ever since have created an increasing successful rate of sacral approach,avoiding too much dissection of presacral tissue and reducing the incidence of postoperative retention of urine.A study of 40 new-born autopsies and some imitate model experiments were made.It showed that this fibrous sheath consists of three parts.the perirectal enveloping fibrous membrane (visceral pelvic fascia);the epirectal adherent fibrous layer (advantitia of rectum);and the para-anal infiltrating fibrous bundles (conjoined longitudinal coat).The epirectal adherent fibrous layer limits the free elasticity of the rectal wall and keeps it a definite lenth and volume and a tubular shape for the cylindrical stool formation,maintaining an intraluminal pressure to induce a defecation reflex,and transmitting the expulsing force to the anal outlet.By cutting the epirectal adherent fibrous layer,the rectal stump will regaia its natural stretching ability which will benefit very much to avoid an abdominal mobilization of the rectum.
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