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首页> 美国卫生研究院文献>Journal of Clinical and Diagnostic Research : JCDR >Evaluation of Clinical Outcomes after Abdominal Rectopexy and Delorme’s Procedure for Rectal Prolapse: A Prospective Study
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Evaluation of Clinical Outcomes after Abdominal Rectopexy and Delorme’s Procedure for Rectal Prolapse: A Prospective Study

机译：腹部直肠切除术和Delorme直肠脱垂手术的临床疗效评估：一项前瞻性研究

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>Background: Complete rectal prolapse is characterized by protrusion of full thickness rectal wall through the anal orifice. Despite its rarity more than 100 surgical procedures have been described and there are no good evidence based recommendations for selection of a surgical procedure. This study was conducted to evaluate the clinical outcomes of commonly used procedures for rectal prolapse at our hospital.>Materials and Methods: Twenty seven patients presenting with complete rectal prolapse between May 2011 to May 2013 were included in this prospective study. Patients underwent either Abdominal rectopexy or Delorme’s procedure after evaluation, based on clinical judgment of experienced surgeons. Patient characteristics, complications, post-operative length of hospitalization and clinical outcomes were assessed. Patients were followed up for a mean duration of 14 months.>Results: Seventeen patients underwent Abdominal rectopexy (Posterior mesh rectopexy), ten patients underwent Delorme’s procedure. No postoperative mortalities or major complications were noted. Post operative morbidity (minor) was 17% in Abdominal rectopexy group and 10% in Delormes group 0%. Incontinence improved in all six patients (100%) in rectopexy group, four patients (80%) in Delorme’s procedure group. Two patients (11%) in rectopexy group reported increase in constipation post operatively. There was one recurrence in Delorme’s procedure group with no recurrences in Abdominal rectopexy group.>Conclusion: The treatment of rectal prolapse should be individualized to achieve best results. Abdominal rectopexy can be safely applied in most of patients with minimal post operative increase in constipation and recurrence by using posterior mesh rectopexy technique. Delorme’s procedure can be performed with minimal morbidity and shorter hospital stay and good functional results with acceptable recurrence rate. Delorme’s can be considered as an alternative to rectopexy not only in patients unfit for laparotomy but also in individuals with a short prolpase, avoiding a laparotomy.
机译：>背景：直肠完全脱垂的特征是直肠全壁穿过肛门口突出。尽管非常罕见，但已描述了100多种手术程序，并且没有基于良好证据的建议来选择手术程序。本研究旨在评估我院常用的直肠脱垂手术的临床结局。>材料与方法：该研究纳入了2011年5月至2013年5月之间有27例完全脱垂的患者研究。根据经验丰富的外科医生的临床判断，对患者进行评估后，应进行腹部直肠切除术或Delorme手术。评估患者特征，并发症，术后住院时间和临床结局。患者接受了平均14个月的随访。>结果：：17例患者接受了腹腔镜视网膜矫正术（后网状视网膜替代术），其中10例患者接受了Delorme手术。没有发现术后死亡或重大并发症。腹部重塑术组的术后发病率（轻微）为17％，而Delormes组为10％，为0％。再狭窄组的所有6名患者（100％）失禁情况得到改善，德洛姆手术组的4名患者（80％）的尿失禁情况得到改善。直肠切除术组中有2例患者（占11％）报告术后便秘增加。 Delorme手术组中只有1例复发，而腹部直肠切除术组中没有复发。>结论：直肠脱垂的治疗应个体化以取得最佳效果。腹腔置换术可以安全地应用在大多数患者中，采用后网状视网膜置换术可以使术后便秘和复发的增加降至最低。 Delorme手术的发病率极低，住院时间较短，功能效果良好，复发率可以接受。 Delorme's不仅可以用于不适合剖腹手术的患者，而且可以用于那些患有短鼻涕的个人，避免进行剖腹手术。

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