Maternini Matteo, Guttadauro Angelo, Pecora Nicoletta, Gabrielli Francesco
Ann Ital Chir. 2016;87:476-480.
To demonstrated the efficacy an safety of a perineal stapled approach to treat the protrusion of the entire layer of the rectum outside the anus in high morbidity patients.
From February 2012 to april 2013, 7 patients (all female, mean age 74,2 years, range 48-88) were operated in our unit with perineal stapled prolapsed resection (PSPR) approach for a full thickness external rectal prolapse.
The duration of hospitalization was 3 days and the follow-up period was 18 months. There were no intraoperative complications and all patients had a bowel movement within 3 days of surgery. There was no mortality. None patients suffered of incontinence. Two patients (28,5%) had a recurrence and proctorragy after 18 months.
PSPR can be considered among perineal approaches for the treatment of full-thickness rectal prolapse. The reported rate of minor complications is low. No major complications have been described. Functional outcome is good, with marked improvement in both continence and constipation.
These results are better than those reported for other perineal procedures, although no randomized trials have yet been published. A multicenter study is needed to better evaluate the indications for and the outcome AFTER PSP.
Morbidity patients, Perineal stapled prolapse resection, Rectal prolapse.
证明会阴吻合器手术治疗高发病率患者肛门外直肠全层脱垂的有效性和安全性。
2012年2月至2013年4月,我们科室对7例患者(均为女性,平均年龄74.2岁,范围48 - 88岁)采用会阴吻合器脱垂切除术(PSPR)治疗全层直肠外脱垂。
住院时间为3天,随访期为18个月。术中无并发症,所有患者术后3天内均排便。无死亡病例。无一例患者出现失禁。2例患者(28.5%)在18个月后复发并出现直肠脱垂。
PSPR可被视为治疗全层直肠脱垂的会阴手术方法之一。报道的轻微并发症发生率较低。未描述有重大并发症。功能结果良好,控便和便秘情况均有明显改善。
尽管尚未发表随机试验报告,但这些结果优于其他会阴手术的报道结果。需要进行多中心研究以更好地评估PSP的适应证和术后结果。
高发病率患者;会阴吻合器脱垂切除术;直肠脱垂