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[直肠脱垂的外科治疗]

[Surgical treatment of rectal prolapse].

作者信息

Mannaerts G H H, Ruseler C H

机构信息

Sint Franciscus Gasthuis, afd. Chirurgie, Kleiweg 500, 3045 PM, Rotterdam.

出版信息

Ned Tijdschr Geneeskd. 2006 Apr 8;150(14):781-7.

Abstract

Rectal prolapse must be distinguished from anal prolapse or mucosal prolapse since the treatment differs. The only effective treatment for rectal prolapse is surgery. The fact that rectal prolapse causes severe disability and that the morbidity of the current surgical treatment is low justifies surgery even at advanced age. Moreover, the success rate is high. Ventral rectopexy seems to be the surgical technique of choice on the grounds of the anatomical advantages (preservation of rectal innervation and lifting of the middle compartment) and the results (low recurrence rates and reduction of constipation). The laparoscopic approach is just as effective as an open procedure and results in less morbidity, quicker recovery and lower medical costs.

摘要

直肠脱垂必须与肛管脱垂或黏膜脱垂相区分,因为治疗方法不同。直肠脱垂唯一有效的治疗方法是手术。直肠脱垂会导致严重残疾,且当前手术治疗的发病率较低,这使得即使是高龄患者也有理由接受手术。此外,成功率很高。基于解剖学优势(保留直肠神经支配和提升中间隔)及手术效果(低复发率和便秘缓解),腹侧直肠固定术似乎是首选的手术技术。腹腔镜手术方法与开放手术同样有效,且发病率更低、恢复更快、医疗成本更低。

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