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直肠脱垂

Rectal prolapse.

作者信息

Gourgiotis Stavros, Baratsis Sotirios

机构信息

Clinical Attachment in Division of General Surgery and Oncology, Royal Liverpool University Hospital, 21 Millersdale Road, Mossley Hill, L18 5HG, Liverpool, UK.

出版信息

Int J Colorectal Dis. 2007 Mar;22(3):231-43. doi: 10.1007/s00384-006-0198-2. Epub 2006 Oct 5.

Abstract

INTRODUCTION

Rectal prolapse, or procidentia, is defined as a protrusion of the rectum beyond the anus. It commonly occurs at the extremes of age. Rectal prolapse frequently coexists with other pelvic floor disorders, and patients have symptoms associated with combined rectal and genital prolapse. Few patients, a lack of randomized trials and difficulties in the interpretation of studies of anorectal physiology have made the understanding of this disorder difficult.

METHODS OF TREATMENT

Surgical management is aimed at restoring physiology by correcting the prolapse and improving continence and constipation, whereas in patients with concurrent genital and rectal prolapse, an interdisciplinary surgical approach is required. Operation should be reserved for those patients in whom medical treatment has failed, and it may be expected to relieve symptoms. Numerous surgical procedures have been suggested to treat rectal prolapse. They are generally classified as abdominal or perineal according to the route of access. However, the controversy as to which operation is appropriate cannot be answered definitively, as the extent of a standardized diagnostic assessment and the types of surgical procedures have not been identified in published series.

LITERATURE REVIEW

This review encompasses rectal prolapse, including aetiology, symptoms and treatment. The English-language literature about rectal prolapse was identified using Medline, and additional cited works not detected in the initial search were obtained. Articles reporting on prospective and retrospective comparisons and case reports were included.

摘要

引言

直肠脱垂,即脱肛,被定义为直肠脱出肛门之外。它常见于年龄极端阶段。直肠脱垂常与其他盆底疾病共存,患者会出现与直肠和生殖器联合脱垂相关的症状。由于患者数量少、缺乏随机试验以及肛门直肠生理学研究解释困难,使得对这种疾病的理解变得困难。

治疗方法

手术治疗旨在通过纠正脱垂以及改善控便和便秘情况来恢复生理功能,而对于同时患有生殖器和直肠脱垂的患者,则需要采用多学科手术方法。手术应仅用于那些药物治疗无效的患者,预期手术可能缓解症状。已经提出了许多手术方法来治疗直肠脱垂。根据手术入路,它们通常分为经腹手术或经会阴手术。然而,由于在已发表的系列研究中尚未确定标准化诊断评估的范围和手术方法的类型,因此无法明确回答哪种手术合适这一争议。

文献综述

本综述涵盖直肠脱垂,包括病因、症状和治疗。使用医学在线数据库(Medline)检索了关于直肠脱垂的英文文献,并获取了在初始检索中未发现的其他引用文献。纳入了报道前瞻性和回顾性比较以及病例报告的文章。

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