Wnęk Bartosz, Waraczewski Krystian, Chalcarz Michał, Kędzia Agnieszka, Lożyńska-Nelke Aleksandra, Hołodyńska Paulina
Pol Przegl Chir. 2013 Aug;85(8):438-45. doi: 10.2478/pjs-2013-0067.
Rectal prolapse belongs to the group of rare diseases of the rectum and anus. It is mostly observed in elderly multiparous women in the seventh and eighth decade. The precise cause of this pathology is not thoroughly understood that is why there are no optimal standards of treatment. The aim of the study was to present pathophysiology, diagnostics and optimal surgical procedures employed in young patients with rectal prolapse.
Out of a 56-patient group treated in Department of General and Colorectal Surgery in the years 2006-2011 a smaller one consisting of 11 young women between the ages 20-40 was selected. According to the literature this is a very rare time of the mentioned pathology occurrence. In the studied females grade of rectal prolapse as well as faecal incontinence based on Jorge-Wexner's (Cleveland) scale were assessed before and after the operative treatment. All of them underwent transabdominal Wells and Frikman-Goldberg prolapse procedures.
Transabdominal approaches repair pathologies of the pelvic floor and have promising longstanding results improving quality of life. No rectal prolapse recurrences were observed. The mean score of the Wexner's grading system was 7.81 diminishing to 1.9 points postoperatively.
Rectal prolapse if untreated, is a pathology that substantially changes patients' quality of life for the worse. Individual, standardized surgical approach to each patient is necessary. Transabdominal methods carry a low risk of complications and improve quality of life of young patients enabling a relatively quick return to normal life.
直肠脱垂属于直肠和肛门的罕见疾病组。多见于七、八十岁的老年经产妇。这种病理的确切病因尚未完全了解,这就是为什么没有最佳治疗标准。本研究的目的是介绍年轻直肠脱垂患者的病理生理学、诊断方法和最佳手术方法。
在2006 - 2011年普通及结直肠外科治疗的56例患者中,选取了一个由11名年龄在20 - 40岁之间的年轻女性组成的较小样本组。根据文献,这是上述病理发生非常罕见的时期。在接受手术治疗前后,对研究中的女性患者进行直肠脱垂分级以及基于豪尔赫 - 韦克斯纳(克利夫兰)量表的大便失禁评估。她们均接受了经腹韦尔斯和弗里克曼 - 戈德堡脱垂手术。
经腹手术方法可修复盆底病变,具有良好的长期效果,可改善生活质量。未观察到直肠脱垂复发。韦克斯纳分级系统的平均评分术前为7.81分,术后降至1.9分。
直肠脱垂若不治疗,会严重恶化患者的生活质量。对每位患者采用个体化、标准化的手术方法是必要的。经腹手术方法并发症风险低,可改善年轻患者的生活质量,使他们能相对较快地恢复正常生活。