Lisi Giorgio, Campanelli M, Grande S, Grande M, Mascagni D, Milito G
Department of General and Pancreatic Surgery, University of Verona, Borgo Roma, Verona, Italy.
Department of General Surgery, University of Modena and Reggio Emilia, Modena, Italy.
Int J Colorectal Dis. 2018 Nov;33(11):1583-1588. doi: 10.1007/s00384-018-3054-2. Epub 2018 Apr 19.
Symptomatic rectocele results in obstructed defecation and constipation. Surgical repair may provide symptomatic relief. A variety of surgical procedures have been used in the rectocele repair to enhance anatomical and functional results and to improve long-term outcomes.
In this prospective study, we treated 25 selected women suffering from simple symptomatic rectocele with transperineal repair using porcine dermal acellular collagen matrix Biomesh (Permacol®). Watson score and SF-36 questionnaire were used to evaluate postoperative outcomes and quality of life.
Follow-up ranged from 12 to 24 months, the mean total Watson score was significantly lower than the preoperative score (P < 0.001), and every patient has improved functional outcomes. There were no major intraoperative or postoperative complications. Two cases of urinary infection and 4 patients delayed wound healing were reported. Those patients who were sexually active prior to surgery have not experienced problems with sexual function or dyspareunia.
Despite lack of comparative study in literature, rectocele repair with Permacol® by the transperineal approach seems an effective and safe procedure that avoids some of the complications associated with synthetic mesh use.
症状性直肠膨出会导致排便梗阻和便秘。手术修复可能会缓解症状。在直肠膨出修复中已采用多种手术方法来提高解剖和功能效果，并改善长期预后。
在这项前瞻性研究中，我们使用猪脱细胞真皮胶原基质生物网片（Permacol®）经会阴修复治疗了25例选定的患有单纯症状性直肠膨出的女性。采用沃森评分和SF - 36问卷评估术后结果和生活质量。
随访时间为12至24个月，平均总沃森评分显著低于术前评分（P < 0.001），且每位患者的功能结局均有改善。无重大术中或术后并发症。报告了2例尿路感染和4例伤口愈合延迟的患者。术前有性生活的患者未出现性功能或性交困难问题。
尽管文献中缺乏对比研究，但经会阴途径使用Permacol®修复直肠膨出似乎是一种有效且安全的手术方法，可避免一些与使用合成网片相关的并发症。
