Delemarre J B, Gooszen H G, Kruyt R H, Soebhag R, Geesteranus A M
Department of Surgery, Leiden University Hospital, The Netherlands.
Dis Colon Rectum. 1991 Apr;34(4):311-6. doi: 10.1007/BF02050590.
Twenty-three patients with rectal prolapse or intussusception were studied to specifically focus on the effect of posterior rectopexy on fecal continence, anal pressure, and rectal capacity. Before operation, five patients were fully continent (A), 10 were continent for solid stools (B) and eight patients were fully incontinent (C). Group A remained fully continent; continence was regained nine times in group B and in group C, three patients regained full continence, two became continent for solid stools, three patients remained incontinent. Other symptoms such as constipation, false urgency, and a feeling of incomplete evacuation were not beneficially influenced by rectopexy. The patients' continence status was correlated to anorectal manometry and rectal capacity measurement. In group B, incremental pressure (P = squeeze - basal P) increased significantly (P less than 0.02) as well as incremental volume (V = maximum tolerated volume - volume of first sensation) (P less than 0.05). We conclude that, by an increase of incremental anal pressure and incremental rectal volume, posterior rectopexy offers an 83 percent chance of regaining full continence, or a major improvement, and a 17 percent chance of stabilization of fecal incontinence.
对23例直肠脱垂或肠套叠患者进行了研究，特别关注直肠后固定术对大便失禁、肛门压力和直肠容量的影响。术前，5例患者完全能控制大便（A组），10例对固体粪便能控制（B组），8例完全大便失禁（C组）。A组仍完全能控制大便；B组9次恢复了控制能力，C组中3例恢复了完全控制能力，2例对固体粪便能控制，3例仍失禁。直肠固定术对便秘、假性便急和排便不尽感等其他症状无有益影响。患者的控便状态与肛门直肠测压及直肠容量测量相关。在B组中，增量压力（P = 挤压时压力 - 基础压力）显著增加（P < 0.02），增量容量（V = 最大耐受容量 - 首次有便意时的容量）也显著增加（P < 0.05）。我们得出结论，通过增加肛门增量压力和直肠增量容量，直肠后固定术有83%的机会恢复完全控便或有显著改善，有17%的机会稳定大便失禁状态。
