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首页> 外文期刊>Surgery Research and Practice >Delorme’s Procedure for Complete Rectal Prolapse: A Study of Recurrence Patterns in the Long Term
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Delorme’s Procedure for Complete Rectal Prolapse: A Study of Recurrence Patterns in the Long Term

机译：Delorme的直肠完全脱垂手术：长期复发模式研究

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Introduction. The objective of this study was to determine the recurrence rate and associated risk factors of full-thickness rectal prolapse in the long term after Delorme’s procedure.Patients and Methods. The study involved adult patients with rectal prolapse treated with Delorme’s surgery between 2000 and 2012 and followed up prospectively in an outpatient unit. We assessed epidemiological data, Wexner constipation and incontinence score, recurrence patterns, and risk factors. Data were analyzed by univariate and multivariate studies and follow-up was performed according to Kaplan-Meier technique. The primary outcome was recurrence.Results. A total of 42 patients, where 71.4% (n=30) were women, with a median age of 76 years (IQR 66 to 86), underwent Delorme’s surgery. The median follow-up was 85 months (IQR 28 to 132). There was no mortality, and morbidity was 9.5%. Recurrence occurred in five patients (12%) within 14 months after surgery. Actuarial recurrence at five years was 9.9%. According to the univariate analysis, constipation and concomitant pelvic floor repair were the only factors found to be associated with recurrence. Multivariate analysis showed no statistically significant differences among variables studied. Kaplan-Meier estimate revealed that constipation was associated with a higher risk of recurrence (log-rank test,p=0.006).Conclusions. Delorme’s procedure is a safe technique with an actuarial recurrence at five years of 9.9%. The outcomes obtained in this study support the performance of concomitant postanal repair and levatorplasty to reduce recurrences. Also, severe constipation is associated with a higher recurrence rate.
机译：介绍。这项研究的目的是确定Delorme手术后长期内全层直肠脱垂的复发率和相关危险因素。这项研究的对象是2000年至2012年间接受Delorme手术治疗的成年直肠脱垂患者，并在门诊进行了随访。我们评估了流行病学数据，韦克斯纳（Wexner）便秘和失禁评分，复发模式以及危险因素。通过单变量和多变量研究分析数据，并根据Kaplan-Meier技术进行随访。主要结果是复发。 Delorme手术总共42例，其中71.4％（n = 30）为女性，中位年龄为76岁（IQR 66至86）。中位随访时间为85个月（IQR 28至132）。没有死亡率，发病率为9.5％。术后14个月内有5例患者（12％）复发。五年的精算复发率为9.9％。根据单因素分析，便秘和伴有骨盆底修复是唯一与复发相关的因素。多变量分析显示，所研究变量之间无统计学差异。 Kaplan-Meier估计显示便秘与更高的复发风险相关（对数秩检验，p = 0.006）。 Delorme的手术是一项安全的技术，五年精算复发率为9.9％。这项研究中获得的结果支持了同时进行的肛门后修补和提肛成形术以减少复发。同样，严重的便秘与更高的复发率相关。

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