改良 Delorme 手术治疗直肠黏膜脱垂。

A modified Delorme's operation for the treatment of rectal mucosal prolapse.

机构信息

Department of Colorectal Surgery, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China, 030012.

出版信息

Int J Colorectal Dis. 2010 May;25(5):607-11. doi: 10.1007/s00384-009-0869-x. Epub 2009 Dec 18.

DOI:10.1007/s00384-009-0869-x

PMID:20020147

Abstract

AIMS

Many procedures have been described for the treatment of rectal internal mucosal prolapse (RMP), but the therapeutic effect is questionable. This work is to evaluate clinical and functional outcome of a modified Delorme's operation-trans-anal purse-string sutures for rectal mucosa and submucosa (TAS) for the treatment of RMP.

METHODS

The clinical data of 58 patients with rectal mucosal prolapse treated with rectal mucosa and submucosal tissue (TAS) between June 2004 and June 2008 were analyzed retrospectively.

RESULTS

No patient died. Satisfaction with surgery was high in 48 cases (82.8%), moderate in seven (12.1%), and low in three (5.17%). Prolapse relapse rate was 5.17%. Anal tenesmus and urge to defecate resolved in 52 (89.7%) patients. Constipation improved in 25 of 28 (89.3%) previously constipated patients. No surgery-associated constipation occurred. The mean operative time was 31 (range 22-46) min. Mean hospital stay was 3 days (range 2-6). Mean patient follow-up was 32 months (range 12-60).

CONCLUSIONS

From our data, TAS for the treatment of RMP showed encouraging results with little complications and an acceptable relapse rate. This economical procedure induces only mild trauma and is easy to perform, making it worthy of further practice and investigation.

摘要

目的

许多方法已被用于治疗直肠内黏膜脱垂（RMP），但疗效存在争议。本研究旨在评估改良 Delorme 手术经肛门荷包缝合直肠黏膜和黏膜下层（TAS）治疗 RMP 的临床和功能结局。

方法

回顾性分析 2004 年 6 月至 2008 年 6 月期间 58 例接受直肠黏膜和黏膜下层（TAS）治疗的直肠黏膜脱垂患者的临床资料。

结果

无患者死亡。48 例（82.8%）对手术非常满意，7 例（12.1%）满意，3 例（5.17%）不满意。脱垂复发率为 5.17%。52 例（89.7%）患者肛门直肠紧迫感和排便急迫感缓解。28 例（89.3%）既往便秘患者便秘改善。无手术相关便秘发生。手术平均时间为 31 分钟（范围 22-46 分钟）。平均住院时间为 3 天（范围 2-6 天）。平均患者随访时间为 32 个月（范围 12-60 个月）。