Hachiro Yoshikazu, Kunimoto Masao, Abe Tatsuya, Kitada Masahiro, Ebisawa Yoshiaki
Department of Proctology, Kunimoto Hospital, 1-7, Akebono, Asahikawa, Japan.
Dis Colon Rectum. 2007 Nov;50(11):1996-2000. doi: 10.1007/s10350-007-9060-z. Epub 2007 Sep 27.
No surgical method for repair of total rectal prolapse has been established as optimal. We describe a new technique that uses ALTA (aluminum potassium sulfate and tannic acid) injection as a simple perianal procedure for total rectal prolapse.
Fourteen patients with total rectal prolapse were treated with sclerosing therapy by using ALTA injection. Via a perianal approach, 0.5 to 1 ml of ALTA solution was injected along a linear track into the submucosa at 30 to 80 different sites, totaling 20 to 60 ml.
All 14 patients treated with injection sclerotherapy were cured, with no intraoperative or postoperative complications. One patient required a repeat injection after two months to be cured. No exacerbation of constipation has resulted, and no stenosis has been evident on rectal examination. In seven of ten patients presenting with fecal incontinence, this complaint resolved after therapy.
ALTA sclerotherapy yielded satisfactory results in total rectal prolapse, causing no alteration in neurophysiology of bowel function. Injection sclerotherapy should be recommended as the first procedure for treatment of total rectal prolapse.
目前尚无已被确立为最佳的全直肠脱垂手术修复方法。我们描述一种新技术，即使用明矾（硫酸铝钾和鞣酸）注射作为一种简单的肛周手术来治疗全直肠脱垂。
14例全直肠脱垂患者接受了明矾注射硬化治疗。通过肛周入路，将0.5至1毫升明矾溶液沿直线轨迹注入30至80个不同部位的黏膜下层，总量为20至60毫升。
所有14例接受注射硬化治疗的患者均治愈，无术中或术后并发症。1例患者在两个月后需要重复注射才能治愈。未导致便秘加重，直肠检查未发现狭窄。在10例有大便失禁的患者中，7例在治疗后此症状消失。
明矾硬化治疗全直肠脱垂效果满意，未引起肠功能神经生理学改变。注射硬化治疗应被推荐为全直肠脱垂治疗的首选方法。
