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对因直肠前壁子宫内膜异位症接受线性吻合器结节切除术患者的术前和术后症状进行评估。

Evaluation of pre- and post-operative symptoms in patients submitted to linear stapler nodulectomy due to anterior rectal wall endometriosis.

作者信息

Kamergorodsky Gil, Lemos Nucelio, Rodrigues Francisco C, Asanuma Fernando Yassuo, D'Amora Paulo, Schor Eduardo, Girão Manoel J B C

机构信息

Pelvic Pain and Endometriosis Unit, Department of Gynecology, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-UNIFESP), Rua Américo Brasiliense, 1479 - 3° andar, São Paulo, 04715-003, SP, Brazil,

出版信息

Surg Endosc. 2015 Aug;29(8):2389-93. doi: 10.1007/s00464-014-3945-4. Epub 2014 Nov 8.

Abstract

BACKGROUND

The objective of this study was to evaluate the feasibility and safety of a more versatile rectosigmoid nodulectomy technique using a linear stapler.

METHODS

Case series.

SETTING

tertiary care (reference center for endometriosis surgery).

PATIENTS

Sixty-one consecutive patients who were operated on between January 2006 and February 2013.

INTERVENTION

anterior rectal wall nodulectomy technique using sequential bites of the linear stapler.

MEASUREMENTS

Perioperative complications were recorded, and a condition-specific bowel dysfunction quality of life questionnaire (Rome III--Constipation) was applied pre-operatively and post-operatively during the first week of April 2013.

DESIGN CLASSIFICATION

Canadian Task Force III RESULTS: A total of 61 patients were submitted to the intervention. After a mean follow-up period of 1.83 years (.25-7.1 ± 1.97), no post-operative fistula or leakage was observed. In addition, no cases of rectal stenosis or bowel obstruction were recorded, and two patients were excluded for not answering the post-operative questionnaire. According to the Rome III questionnaire, constipation symptoms improved significantly in 12 out of 17 questions. No patient reported worsening of symptoms in question.

CONCLUSIONS

Linear stapler resection is a safe alternative to segmentar resection for endometriotic nodules on the anterior rectal wall.

摘要

背景

本研究的目的是评估使用线性吻合器进行更通用的直肠乙状结肠结节切除术技术的可行性和安全性。

方法

病例系列研究。

地点

三级医疗中心(子宫内膜异位症手术参考中心)。

患者

2006年1月至2013年2月期间连续接受手术的61例患者。

干预措施

使用线性吻合器逐次咬合进行直肠前壁结节切除术。

测量指标

记录围手术期并发症,并在2013年4月的第一周术前和术后应用特定疾病的肠功能障碍生活质量问卷(罗马III型——便秘)。

设计分类

加拿大工作组III级

结果

共有61例患者接受了该干预措施。平均随访1.83年(0.25 - 7.1 ± 1.97)后,未观察到术后瘘管或渗漏。此外,未记录到直肠狭窄或肠梗阻病例,2例患者因未回答术后问卷而被排除。根据罗马III型问卷,17个问题中有12个问题的便秘症状明显改善。没有患者报告症状恶化。

结论

对于直肠前壁的子宫内膜异位结节,线性吻合器切除术是节段性切除术的一种安全替代方法。

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