会阴直肠乙状结肠切除术（阿尔特迈尔手术）治疗绞窄性直肠脱垂

Perineal Rectosigmoidectomy (Altemeier Procedure) as Treatment of Strangulated Rectal Prolapse.

作者信息

Cernuda Ricardo Baldonedo, Ángel Janet Pagnozzi, Fernández Nuria Truan, Sánchez-Farpón José Herminio, Pérez Jose Antonio Álvarez

机构信息

Division of Coloproctology, Department of Surgery, Hospital Universitario Central de Asturias, C/Cardenal Cienfuegos 2 esc 2 8°d 33007 Avenida de Roma, s/n 33011, Oviedo, Spain.

Department of Surgery, Hospital Universitario Central de Asturias, Avenida de Roma, s/n 33011, Oviedo, Spain.

出版信息

J Gastrointest Surg. 2016 Dec;20(12):2102-2103. doi: 10.1007/s11605-016-3190-3. Epub 2016 Jul 6.

DOI:10.1007/s11605-016-3190-3

PMID:27384429

Abstract

Incarceration of a rectal prolapse is an unusual entity that represents a surgical emergency. Even more rarely, it becomes strangulated, requiring emergency surgery. When surgery becomes inevitable, the choice of procedure varies. A 57-year-old man who presented with strangulated rectal prolapse is described. The patient underwent emergency perineal proctosigmoidectomy, the Altemeier operation, combined with diverting loop sigmoid colostomy. The postoperative course was uneventful. After a 6-month follow-up, there was no recurrence, but the patient continued with fecal incontinence. This case underlines the importance of the Altemeier procedure as treatment in the patient with a strangulated prolapsed rectal segment.

摘要

直肠脱垂嵌顿是一种不常见的情况，属于外科急症。更罕见的是，它会发生绞窄，需要急诊手术。当手术成为必然选择时，手术方式的选择各不相同。本文描述了一名57岁因绞窄性直肠脱垂就诊的男性患者。该患者接受了急诊经会阴直肠乙状结肠切除术（阿尔特迈尔手术），并联合转流性袢状乙状结肠造口术。术后过程顺利。经过6个月的随访，没有复发，但患者仍存在大便失禁。该病例强调了阿尔特迈尔手术在治疗绞窄性直肠脱垂患者中的重要性。