Schwandner Thilo, Roblick Michael H, Hecker Andreas, Brom Armand, Kierer Walter, Padberg Winfried, Hirschburger Markus
Department of General and Thoracic Surgery, Justus-Liebig-University Giessen, Giessen, Germany.
Int J Colorectal Dis. 2009 Dec;24(12):1429-34. doi: 10.1007/s00384-009-0790-3. Epub 2009 Aug 11.
Widely differing surgical methods have been propagated to correct symptomatic rectocele. With transvaginal rectal repair (TVRR), we evaluate a method to reestablish the continuity of the rectal muscle wall, strengthen the weakened tunica muscularis, and restore normal rectal capacity and function.
Between 1997 and 2003, 102 female patients were treated by TVRR in cases of symptomatic rectocele. Patients without improvement following a stringent conservative treatment for a minimum of 3-6 months were selected for TVRR procedure. Patients with intussusception and slow-transit constipation were excluded from the study. To achieve optimal stabilization of the rectal wall, a transverse gathering of the rectocele was performed by a transvaginal access.
Average patient age was 60.9 years (47-76 years), operation time was 36.5 minutes (29-67 min.), in-hospital treatment lasted 4.1 days (2-7 days), and follow-up was 18.1 months (3-48 months). We observed complications in 11% of cases. Three months after the operation, 81% of the patients were symptom-free or improved. Following an average observation time of 18.1 months (3-48 months), 70% were still symptom-free or improved.
TVRR allows easy access for rectocele repair with a low rate of complications.
为纠正有症状的直肠膨出，人们推广了多种截然不同的手术方法。通过经阴道直肠修补术（TVRR），我们评估了一种重建直肠肌壁连续性、加强薄弱肌层并恢复直肠正常容量和功能的方法。
1997年至2003年间，102例有症状直肠膨出的女性患者接受了TVRR治疗。选择经过至少3 - 6个月严格保守治疗后无改善的患者进行TVRR手术。研究排除了患有肠套叠和慢传输型便秘的患者。为实现直肠壁的最佳稳定，经阴道入路对直肠膨出进行横向聚拢。
患者平均年龄为60.9岁（47 - 76岁），手术时间为36.5分钟（29 - 67分钟），住院治疗持续4.1天（2 - 7天），随访时间为18.1个月（3 - 48个月）。我们观察到11%的病例出现并发症。术后三个月，81%的患者症状消失或改善。经过平均18.1个月（3 - 48个月）的观察期后，70%的患者仍无症状或症状改善。
TVRR使直肠膨出修补术操作简便，并发症发生率低。
