Schwandner O
Abteilung für Proktologie, Krankenhaus Barmherzige Brüder Regensburg, Prüfeninger Str. 86, 93049, Regensburg, Deutschland.
Chirurg. 2016 Nov;87(11):985-998. doi: 10.1007/s00104-016-0287-x.
Anterior rectocele is a common morphological condition in patients with obstructive defecation syndrome. Typical symptoms include incomplete evacuation, transanal or transvaginal digitation and soiling, which is frequently interpreted as fecal incontinence. Diagnosis of rectocele is made clinically and functional assessment of rectocele can be performed by dynamic imaging, e.g. by magnetic resonance (MR) defecography. Primary treatment should be conservative. Concerning surgical treatment, transanal, transperineal, transvaginal and transabdominal procedures are available. Evidence-based guidelines for surgical treatment are still lacking. The question whether rectocele is a cause or a consequence of obstructive defecation syndrome remains controversial. Accordingly, indications for surgical correction of rectocele should be considered with caution.
直肠前突是排便梗阻综合征患者常见的形态学病症。典型症状包括排便不尽、经肛门或经阴道指诊及便污，后者常被视为大便失禁。直肠前突的诊断依靠临床判断，其功能评估可通过动态成像进行，如磁共振（MR）排粪造影。初始治疗应以保守治疗为主。关于手术治疗，有经肛门、经会阴、经阴道及经腹手术方式。目前仍缺乏手术治疗的循证指南。直肠前突是排便梗阻综合征的病因还是结果这一问题仍存在争议。因此，直肠前突手术矫正的指征应谨慎考虑。
