Colorectal Surgery Section, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Department of Surgery, Federal University of Minas Gerais, School of Medicine, Belo Horizonte, MG, Brazil.
Am J Surg. 2020 Sep;220(3):697-705. doi: 10.1016/j.amjsurg.2020.01.017. Epub 2020 Jan 17.
Rectal prolapse is relatively uncommon in male patients. The aim of this study was to compare males and females who underwent rectal prolapse surgery.
Retrospective analysis of the ACS NSQIP public use file.
Among 12,220 patients, 978 (8%) were male and 11,242 (92%) were female. Males were younger, 56 (38-73) vs. 71 (58-83) years, less often white (83% vs. 71%), had lower ASA scores, and underwent more laparoscopic (33% vs. 27%), more open (33% vs. 29%), and less perineal (33% vs 44%) procedures (all p < 0.05). Morbidity (9.9% vs. 10.0%), reoperation (3.4% vs. 3.1%), and readmission (5.7% vs. 6.0%) were not different for males and females. In subgroup analysis by surgical procedure type, there remained no outcome differences. Propensity matched analysis revealed no difference in the use of laparoscopic, open, or perineal procedures.
Males with rectal prolapse are younger, have a different racial distribution, a lower surgical risk profile, and undergo different surgical procedures than females, which appears to be driven by patient age and surgical risk assessment.
直肠脱垂在男性患者中相对少见。本研究旨在比较接受直肠脱垂手术的男性和女性患者。
回顾性分析 ACS NSQIP 公共使用文件。
在 12220 名患者中，978 名（8%）为男性，11242 名（92%）为女性。男性更年轻，56（38-73）岁 vs. 71（58-83）岁，白人比例较低（83% vs. 71%），ASA 评分较低，接受腹腔镜手术的比例更高（33% vs. 27%），开放手术的比例更高（33% vs. 29%），会阴手术的比例较低（33% vs. 44%）（均 P<0.05）。男性和女性的发病率（9.9% vs. 10.0%）、再次手术（3.4% vs. 3.1%）和再入院率（5.7% vs. 6.0%）没有差异。按手术类型进行亚组分析，结果仍无差异。倾向评分匹配分析显示，腹腔镜、开放或会阴手术的使用无差异。
与女性相比，直肠脱垂男性更年轻，种族分布不同，手术风险较低，接受的手术方式也不同，这似乎是由患者年龄和手术风险评估驱动的。
