Liberman H, Hughes C, Dippolito A
Department of Surgery, Creighton University School of Medicine, Omaha, Nebraska 68131-2197, USA.
Dis Colon Rectum. 2000 Feb;43(2):188-92. doi: 10.1007/BF02236980.
This study was designed to assess the results of the Delorme procedure in the treatment of patients with rectal outlet obstruction.
A descriptive retrospective study from October 1989 to October 1997 was undertaken. Thirty-four patients with an abnormal defecography documenting rectal outlet obstruction caused by internal rectal prolapse or a combination of internal rectal prolapse and rectocele were included in the study.
Thirty-four patients (33 females) ages 35 to 82 (mean, 61.4) years were followed up for the duration of the study (mean follow-up, 43 months). Twenty-six patients (76.4 percent) reported a good to excellent overall result after the Delorme procedure. Eight patients (23.6 percent) reported fair to poor results. Symptomatic improvement was observed in 89.7 percent for patients who had incomplete evacuation, and in 88.5 percent of patients who had constipation. There was improvement in 78.6 percent of patients with bleeding per rectum, in 92.9 percent of patients with straining, and in 82.4 percent of patients with the need to manually assist in defecation by pushing in the perineum or vagina. Discontinuation of laxative use after the procedure was reported by 66.7 percent of patients. Improvement in the patients with some degree of incontinence was seen in 33.3 percent. Twelve patients (35.3 percent) experienced one or more complications. The procedure was performed in an outpatient setting in 71 percent of the patients.
The Delorme procedure for the treatment of rectal outlet obstruction can be done with minimal morbidity, short hospital stay often in an outpatient setting, with good functional results, and with an overall patient satisfaction above 75 percent.
本研究旨在评估Delorme手术治疗直肠出口梗阻患者的效果。
进行了一项从1989年10月至1997年10月的描述性回顾性研究。研究纳入了34例排粪造影异常、记录有直肠内脱垂或直肠内脱垂合并直肠膨出导致直肠出口梗阻的患者。
34例患者（33例女性），年龄35至82岁（平均61.4岁），在研究期间接受随访（平均随访43个月）。26例患者（76.4%）报告Delorme手术后总体效果良好至极佳。8例患者（23.6%）报告效果一般至较差。排便不完全的患者中89.7%症状改善，便秘患者中88.5%症状改善。直肠出血患者中有78.6%症状改善，用力排便患者中有92.9%症状改善，需要通过会阴或阴道推挤手动辅助排便的患者中有82.4%症状改善。66.7%的患者术后停止使用泻药。33.3%的有一定程度失禁的患者症状改善。12例患者（35.3%）出现一种或多种并发症。71%的患者在门诊进行了该手术。
Delorme手术治疗直肠出口梗阻，发病率低，住院时间短，常可在门诊进行，功能效果良好，患者总体满意度超过75%。
