Finco Cristiano, Luongo Barbara, Savastano Silvia, Polato Francesca, Sarzo Giacomo, Caruso Valentina, De Lazzari Franca, Merigliano Stefano
3rd General Surgery Clinic, Department of Medical and Surgical Sciences, Coloproctological Unit, S. Antonio Hospital, University of Padua.
Chir Ital. 2007 Jul-Aug;59(4):513-20.
The aim of this study was to evaluate the impact of applying strict selection criteria to patients with symptoms of obstructed defecation, rectocele and rectal prolapse who were candidates for surgery. From June 2001 to September 2003, 20 patients underwent surgery in our clinic for symptomatic rectocele and anorectal prolapse. They were evaluated prospectively using a dedicated questionnaire (KESS), a proctological and gynaecological examination, colpo-cysto-defecography and anorectal manometry before surgery and 6 months postoperatively. Strict selection criteria were used for surgery. After 6 months the questionnaire showed an important improvement in symptoms. The symptoms of obstructed defecation and vaginal bulging improved significantly. The average KESS score dropped from 17.65 preoperatively to 5.8 six months after surgery. In the treatment of pelvic floor disease, it is important to evaluate both the uro-gynaecological and the proctological symptoms with the utmost care, obtaining an accurate clinical picture with the aid of dedicated questionnaires and a thorough clinical examination. Evaluation of the effectiveness of surgery for constipation necessarily includes assessing the strength of the indications for surgery, irrespective of the surgical technique adopted, but there is currently no standardised test method for recording and comparing the symptoms of constipation.
本研究的目的是评估对有排便梗阻、直肠膨出和直肠脱垂症状且适合手术的患者应用严格选择标准的影响。2001年6月至2003年9月,20例患者在我们诊所接受了有症状直肠膨出和肛肠脱垂的手术。在手术前及术后6个月,使用专门的问卷(KESS)、直肠科和妇科检查、阴道膀胱直肠造影术及肛肠测压法对他们进行前瞻性评估。手术采用严格的选择标准。6个月后问卷显示症状有显著改善。排便梗阻和阴道膨出症状明显改善。KESS平均评分从术前的17.65降至术后6个月的5.8。在盆底疾病的治疗中,极其谨慎地评估泌尿妇科和直肠科症状很重要,借助专门问卷和全面的临床检查获取准确的临床情况。评估便秘手术的有效性必然包括评估手术指征的强度,无论采用何种手术技术,但目前尚无记录和比较便秘症状的标准化测试方法。