Harris Marsha A, Ferrara Andrea, Gallagher Joseph, DeJesus Samuel, Williamson Paul, Larach Sergio
Colon and Rectal Clinic of Orlando, Orlando Regional Health System, Orlando, Florida, USA.
Dis Colon Rectum. 2009 Apr;52(4):592-7. doi: 10.1007/DCR.0b013e31819edbb1.
Stapled transanal rectal resection has been introduced as a new technology for the management of obstructive defecation syndrome. In this study we observed the clinical outcomes for stapled transanal rectal resection as compared with transvaginal rectocele repair for obstructive defecation syndrome.
This study is a retrospective review of patients who received transvaginal rectocele repair for obstructive defecation syndrome from June 1997 to February 2002 as compared with patients who received stapled transanal rectal resection from June 2005 to August 2007. The clinical outcomes observed were operative time, estimated blood loss, length of stay, complication rate, procedure failure rate, recurrence rate, time to recurrence, and dyspareunia rate.
Thirty-seven patients had transvaginal rectocele repair for management of obstructive defecation syndrome, and 36 patients had stapled transanal rectal resection. There was no difference in the age of patients receiving either procedure (transvaginal rectocele repair, 57.92 years old; stapled transanal rectal resection, 53.19 years old; P = 0.1096). Evaluation of the clinical outcomes showed that transvaginal rectocele repair had a longer operative time (transvaginal rectocele repair, 85 minutes; stapled transanal rectal resection, 52 minutes; P = or<0.0001), greater estimated blood loss (transvaginal rectocele repair, 108 ml; stapled transanal rectal resection, 43 ml; P = 0.0015), and a lower complication rate (transvaginal rectocele repair, 18.9 percent; stapled transanal rectal resection, 61.1 percent; P = 0.0001).
The stapled transanal rectal resection procedure can be done with shorter operative times and less blood loss than transvaginal rectocele repair, however, it has a higher complication rate.
吻合器经肛门直肠切除术已作为一种治疗排便梗阻综合征的新技术被引入。在本研究中，我们观察了吻合器经肛门直肠切除术与经阴道直肠膨出修补术治疗排便梗阻综合征的临床疗效。
本研究是一项回顾性研究，比较了1997年6月至2002年2月接受经阴道直肠膨出修补术治疗排便梗阻综合征的患者与2005年6月至2007年8月接受吻合器经肛门直肠切除术的患者。观察的临床疗效包括手术时间、估计失血量、住院时间、并发症发生率、手术失败率、复发率、复发时间和性交困难发生率。
37例患者接受经阴道直肠膨出修补术治疗排便梗阻综合征，36例患者接受吻合器经肛门直肠切除术。接受两种手术的患者年龄无差异（经阴道直肠膨出修补术患者57.92岁；吻合器经肛门直肠切除术患者53.19岁；P = 0.1096）。临床疗效评估显示，经阴道直肠膨出修补术的手术时间更长（经阴道直肠膨出修补术85分钟；吻合器经肛门直肠切除术52分钟；P =或<0.0001），估计失血量更多（经阴道直肠膨出修补术108毫升；吻合器经肛门直肠切除术43毫升；P = 0.0015），并发症发生率更低（经阴道直肠膨出修补术18.9%；吻合器经肛门直肠切除术61.1%；P = 0.0001）。
与经阴道直肠膨出修补术相比，吻合器经肛门直肠切除术的手术时间更短，失血量更少，然而，其并发症发生率更高。
