Bakshi G, Ranka S, Agarwal S, Shetty S V
Department of Surgery, Seth G. S. Medical College, Vile Parle, Mumbai, India.
J Postgrad Med. 2000 Oct-Dec;46(4):265-7.
To evaluate the efficacy of modified mesh rectopexy for complete rectal prolapse.
In a prospective study between 1989-1998, 47 patients (25 males and 22 females) underwent modified mesh rectopexy using a "Cross-shaped" knitted monofilament polypropylene. They were followed up for a period of four years postoperatively.
Anatomical repair was achieved in all patients. Preoperative constipation, a complaint in 22 patients, was relieved in 13 patients and need for laxatives decreased in another four. There were no new cases of constipation. Sexual functions were not hampered irrespective of gender. The complications included prolonged ileus (4 patients), faecal impaction (1), partial mucosal prolapse (2) and post-operative obstruction (2). There was no recurrence.
This technique aligns the rectum, avoids excessive mobilisation and division of lateral ligaments thus preventing constipation and preserving potency. We recommend this technique for patients with complete rectal prolapse with up to grade 1, 2 and 3 incontinence based on Browning and Parks classification.
评估改良网状直肠固定术治疗完全性直肠脱垂的疗效。
在1989年至1998年的一项前瞻性研究中，47例患者（25例男性和22例女性）采用“十字形”针织单丝聚丙烯进行改良网状直肠固定术。术后对他们进行了四年的随访。
所有患者均实现解剖修复。术前有22例患者存在便秘，其中13例便秘得到缓解，另外4例对泻药的需求减少。没有出现新的便秘病例。无论性别，性功能均未受到影响。并发症包括肠梗阻延长（4例）、粪便嵌塞（1例）、部分黏膜脱垂（2例）和术后梗阻（2例）。无复发情况。
该技术可使直肠复位，避免过度游离和切断侧韧带，从而预防便秘并保留性功能。对于根据布朗宁和帕克斯分类法诊断为完全性直肠脱垂且失禁程度达1、2和3级的患者，我们推荐使用该技术。
