Roberts P L, Schoetz D J, Coller J A, Veidenheimer M C
Department of Colon and Rectal Surgery, Lahey Clinic Medical Center, Burlington, MA 01805.
Arch Surg. 1988 May;123(5):554-7. doi: 10.1001/archsurg.1988.01400290036005.
We reviewed our 22-year experience with 135 Ripstein procedures for rectal prolapse in 118 women and 17 men. Follow-up ranged from one to 256 months (median, 41 months). Five patients were unavailable for follow-up. There was one perioperative death (0.7%). Complications included hemorrhage from presacral veins in 11 patients (8.1%), recurrent prolapse in 13 patients (9.6%), and stricture at the site of the sling in three patients (2.2%). Specific intraoperative technical factors could be related to recurrent prolapse in four patients (30.8%). Attention to technical details is mandatory to minimize immediate and long-term complications. Patients should be prepared for anterior resection, since a sling procedure may be inadvisable at the time of exploration. Resection may be the preferred operation for men, who have a high rate of recurrent prolapse with the Ripstein procedure.
我们回顾了22年间对118名女性和17名男性进行的135例用于直肠脱垂的Ripstein手术的经验。随访时间为1至256个月（中位数为41个月）。5例患者无法进行随访。围手术期死亡1例（0.7%）。并发症包括11例（8.1%）骶前静脉出血、13例（9.6%）复发脱垂和3例（2.2%）吊带部位狭窄。4例患者（30.8%）的复发脱垂可能与特定的术中技术因素有关。必须注意技术细节以尽量减少近期和远期并发症。患者应做好前切除术的准备，因为在探查时吊带手术可能不可行。对于男性患者，切除术可能是首选手术，因为Ripstein手术的复发脱垂率较高。
