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使用 Contour® Transtar™ 吻合器行经肛直肠切除术的早期并发症。

Early complications after stapled transanal rectal resection performed using the Contour® Transtar™ device.

机构信息

General Surgery I, University of Siena, Siena, Italy.

出版信息

Colorectal Dis. 2011 Dec;13(12):1428-31. doi: 10.1111/j.1463-1318.2010.02466.x.

Abstract

AIM

This study evaluated the early results (with particular reference to complications) of stapled transanal rectal resection (STARR) carried out using the CCS-30 Contour® Transtar™ device. The procedure was performed in a single centre on patients with obstucted defecation caused by rectocele or rectal intussusception.

METHOD

From July 2007 to February 2009, 133 patients were treated. Preoperatively, all underwent clinical examination, transanal ultrasonography, anorectal manometry and cinedefaecography. Obstructed defaecation syndrome was assessed using the Cleveland Clinic Constipation Score (CCC-S). Early postoperative complications and those occurring within 6 months were recorded.

RESULTS

The median follow-up period was 19 (range 12-30) months. The mean ± standard deviation preoperative CCC-S of 19.4 ± 7.1 decreased to 10.1 ± 9.0 postoperatively. The early complication rate was 15.7% and included rectovaginal fistula (n = 1), rectal perforation (n = 1), posterior dehiscence (n = 4), further surgery for retained staples (n = 2), postoperative bleeding (n = 2) and postoperative impaired continence (n = 11).

CONCLUSIONS

STARR using the Contour Transtar device seems to be effective for treating obstructed defaecation. However, serious complications may occur.

摘要

目的

本研究评估了使用 CCS-30 Contour® Transtar™ 器械进行吻合器经肛直肠切除术(STARR)的早期结果(特别参考并发症)。该手术在一家中心对因直肠前突或直肠套叠引起的排便梗阻的患者进行。

方法

2007 年 7 月至 2009 年 2 月,共治疗了 133 例患者。所有患者术前均行临床检查、经肛直肠超声、肛肠测压和排粪造影检查。采用克利夫兰便秘评分(CCC-S)评估梗阻性排便综合征。记录早期术后并发症和 6 个月内发生的并发症。

结果

中位随访时间为 19 个月(范围 12-30 个月)。术前 CCC-S 的均数±标准差为 19.4±7.1,术后降至 10.1±9.0。早期并发症发生率为 15.7%,包括直肠阴道瘘(n=1)、直肠穿孔(n=1)、后缘裂开(n=4)、因遗留吻合钉而需进一步手术(n=2)、术后出血(n=2)和术后控便障碍(n=11)。

结论

使用 Contour Transtar 器械的 STARR 似乎对治疗排便梗阻有效,但可能发生严重并发症。

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