Farag A, Mashhour A N, Elbarmelgi M Y, Raslan M M, Abdelsalam A M, Mohsen A A
Department of General Surgery, Cairo University , Egypt.
Ann R Coll Surg Engl. 2017 Sep;99(7):555-558. doi: 10.1308/rcsann.2017.0085. Epub 2017 Jul 6.
Background and purpose The functional outcomes of incontinence and high stool frequency resulting from restorative surgery are often criticised. The aim of this study was to assess the taeniectomy pouch in comparison with other pouches described in the literature. Material and methods This was a prospective cohort study. All patients who were candidate for low rectal resection presenting to the colorectal unit at Cairo University hospitals during the period February 2013 to February 2015 were included in the study (90 patients). Safety and feasibility of the new technique were assessed, including operative time, leakage, postoperative urgency, incontinence, number of daily motions and difficulty in evacuation. These parameters were assessed clinically, by means of defecography and anorectal manometry. Results The mean age of patients was 49.6 years. Percentages of postoperative mortality and leakage were 2.2% and 3.4%, respectively. Mean operative time was 117 minutes. Mean numbers of daily motions were 3.04 and 1.52 at 3 and 12 months, respectively. Mean Wexner score for continence at 3 and 12 months were 3.21 and 1.32, respectively. Mean resting pressure was 51.63 mmHg, squeeze pressure was 130.42 mmHg and mean threshold volume was 118.68 ml. Conclusions Taeniectomy is a novel technique for pouch formation after low rectal resection, which can be used as an alternative to other pouches, especially the widely used transverse coloplasty.
背景与目的 修复性手术导致的大小便失禁和高排便频率的功能结局常遭诟病。本研究旨在将带状结肠切除术贮袋与文献中描述的其他贮袋进行比较评估。材料与方法 这是一项前瞻性队列研究。纳入了2013年2月至2015年2月期间在开罗大学医院结直肠科就诊、适合低位直肠切除术的所有患者(90例)。评估了新技术的安全性和可行性,包括手术时间、渗漏情况、术后尿急、失禁、每日排便次数及排便困难程度。通过排粪造影和肛肠测压对这些参数进行临床评估。结果 患者的平均年龄为49.6岁。术后死亡率和渗漏率分别为2.2%和3.4%。平均手术时间为117分钟。3个月和12个月时的平均每日排便次数分别为3.04次和1.52次。3个月和12个月时的控便Wexner平均评分分别为3.21分和1.32分。平均静息压力为51.63 mmHg,挤压压力为130.42 mmHg,平均阈值容量为118.68 ml。结论 带状结肠切除术是低位直肠切除术后形成贮袋的一种新技术,可作为其他贮袋的替代方法,尤其是广泛应用的横结肠成形术。