Ayav A, Bresler L, Brunaud L, Boissel P
Department of Digestive Surgery, University Hospital Nancy-Brabois, Vandoeuvre les Nancy, France.
Dis Colon Rectum. 2004 Jun;47(6):889-94. doi: 10.1007/s10350-004-0527-x. Epub 2004 Apr 19.
This study was designed to determine the long-term outcomes of transanal rectocele repair using a linear stapler.
Between 1989 and 1999, 21 patients with symptomatic rectocele were enrolled for this study. Median age at time of presentation was 52 (range, 21-75) years. All patients underwent a transanal repair using a linear stapler. End evaluation to assess long-term results was performed after a median duration of follow-up of 58 (range, 12-118) months. Patients were asked about current problems with constipation, use of laxatives, incontinence, vaginal digitalization, presence of vaginal bulge, pain, bleeding, and sexual dysfunction.
The postoperative course was uneventful in all cases. Sixteen (76 percent) patients had symptomatic relief. The operation reduced symptoms of obstructed defecation (21 vs. 5, preoperative vs. postoperative; P < 0.001) and the need of vaginal digitalization (21 vs. 6; P < 0.001). Only three patients (14 percent) showed no sign of improvement. Two patients (9 percent) had temporary improvement for three years before recurrence.
Transanal repair of rectocele using a linear stapler is an easy, safe, and useful procedure for the correction of symptomatic rectocele. Successful long-term outcome can be achieved with this procedure.
本研究旨在确定使用线性吻合器经肛门修复直肠膨出的长期疗效。
1989年至1999年期间，21例有症状的直肠膨出患者纳入本研究。就诊时的中位年龄为52岁（范围21 - 75岁）。所有患者均使用线性吻合器进行经肛门修复。在中位随访期58个月（范围12 - 118个月）后进行最终评估以评估长期结果。询问患者目前便秘、使用泻药、失禁、阴道指诊、阴道膨出、疼痛、出血及性功能障碍等问题。
所有病例术后过程均顺利。16例（76%）患者症状缓解。手术减轻了排便梗阻症状（术前21例，术后5例；P < 0.001）以及阴道指诊需求（21例对6例；P < 0.001）。仅3例患者（14%）无改善迹象。2例患者（9%）在复发前有3年的短暂改善。
使用线性吻合器经肛门修复直肠膨出是一种治疗有症状直肠膨出的简便、安全且有效的方法。该手术可取得成功的长期疗效。
