Fang Chia Bin, Candelária Paulo de Azeredo Passos, Klug Wilmar Artur, Capelhuchnik Peretz
Departamento de Cirurgia da Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP.
Rev Assoc Med Bras (1992). 2008 Mar-Apr;54(2):142-5. doi: 10.1590/s0104-42302008000200017.
Rectopexy is the most common technique used to correct rectal prolapse. Perineal procedures such as the Delorme technique and others are employed for older frail patients with significant comorbidity because of the higher recurrence rate. This study evaluated results of the Delorme technique and rectopexy.
Retrospective study of 31 patients with rectal prolapse treated from 1997 to 2005. Among them, 15 patients (group A) were treated by rectopexy and 16 by the Delorme technique (group B). Analysis of hospital stay, morbidity, complications and recurrence rate was carried out.
There was longer hospital stay, seven days (3 to 11days) in group A, compared to four days (2 to 6 days) in group B. Recurrence rate was similar, respectively 13.3% and 6.6% (not significant). Most patients presented low rest and squeezing pressure, although half of them became fully continent after surgery (group A=53% and group B =50%). Morbidity was 40% and 18.9%, respectively for groups A and B. Sacral hemorrhage occurred in one patient and was controlled during rectopexy. A case of bleeding occurred in group B and ceased spontaneously without surgical procedure. There was a rectal stricture in group B treated successfully with digital dilatation at the doctor's office.
The Delorme technique for treatment of rectal prolapse is a safe procedure and presents results similar to rectopexy. In addition it also has lower morbidity, and could be more often indicated.
直肠固定术是纠正直肠脱垂最常用的技术。由于复发率较高，会阴手术如德洛姆技术等用于患有严重合并症的老年体弱患者。本研究评估了德洛姆技术和直肠固定术的效果。
对1997年至2005年治疗的31例直肠脱垂患者进行回顾性研究。其中，15例患者（A组）接受直肠固定术治疗，16例接受德洛姆技术治疗（B组）。对住院时间、发病率、并发症和复发率进行分析。
A组住院时间较长，为7天（3至11天），而B组为4天（2至6天）。复发率相似，分别为13.3%和6.6%（无显著性差异）。大多数患者静息和挤压压力较低，尽管其中一半患者术后完全控便（A组=53%，B组=50%）。A组和B组的发病率分别为40%和18.9%。1例患者在直肠固定术中出现骶部出血并得到控制。B组有1例出血病例，未经手术自行停止。B组有1例直肠狭窄，在医生办公室通过手指扩张成功治疗。
德洛姆技术治疗直肠脱垂是一种安全的手术，效果与直肠固定术相似。此外，其发病率较低，可更频繁地应用。
