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首页> 外文期刊>Journal of Clinical and Diagnostic Research >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手术治疗直肠脱垂后的临床疗效评估：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 charac teristics, 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 individu - alized 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推荐手术程序选择建议。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：前瞻性研究包括2011年5月至2013年5月之间有27例完全直肠脱垂的患者。根据经验丰富的外科医生的临床判断，患者应在评估后接受腹部直肠切除术或Delorme手术。评估患者的特征，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例患者接受了腹部直肠造形术（后网状视网膜替代术），其中10例接受了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％。再狭窄组的所有六名患者（100％）的尿失禁得到改善，德洛尔梅手术组的四名患者（80％）的尿失禁得到改善。直肠切除术组中有2例患者（11％）报告术后便秘增加。 Delorme's手术组仅有1例复发，而腹部直肠切除术组无复发。结论：应单独进行直肠脱垂的治疗，以取得最佳效果。腹腔镜置入术可以通过大多数手术后的便秘和复发而安全地应用到大多数患者中。 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，从而避免进行剖腹手术，从而可以替代再狭窄。

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