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直肠脱垂的外科治疗:单机构10年经验

Surgical Treatment of Rectal Prolapse: A 10-Year Experience at a Single Institution.

作者信息

Nacion Aeris Jane D, Park Youn Young, Kim Ho Seung, Yang Seung Yoon, Kim Nam Kyu

机构信息

Department of Surgery, Eastern Visayas Regional Medical Center, Tacloban, Philippines.

Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

J Minim Invasive Surg. 2019 Dec 15;22(4):164-170. doi: 10.7602/jmis.2019.22.4.164.

Abstract

PURPOSE

Despite the plethora of surgical options, there is no consensus regarding the best treatment for rectal prolapse. This study is aimed at evaluating our experience with its treatment and outcomes.

METHODS

We retrospectively reviewed rectal prolapse patients' characteristics, clinical presentation, surgical procedure, average length of hospital stay, morbidity, mortality, and recurrence over a 10 year period at our institution.

RESULTS

A total of 46 patients underwent rectal prolapse repair at our institution over a 10 year period. Of the 39 patients with primary rectal prolapse, 18 patients had an abdominal procedure, while 21 patients underwent a perineal approach. Operative duration was significantly longer in abdominal procedures, of which 16 cases were performed laparoscopically. Length of hospital stay and recurrence were not statistically significant between the 2 groups. In patients with recurrent rectal prolapse, more than 80% of the initial surgeries were done using the perineal approach. An abdominal approach was utilized in the management of 75% of recurrences.

CONCLUSION

An abdominal repair may be preferable in the treatment of recurrent rectal prolapse. Minimally invasive techniques may be feasible and can provide a safe alternative to perineal procedures in elderly patients.

摘要

目的

尽管有大量的手术选择,但对于直肠脱垂的最佳治疗方法尚无共识。本研究旨在评估我们在其治疗及结果方面的经验。

方法

我们回顾性分析了本机构10年间直肠脱垂患者的特征、临床表现、手术方式、平均住院时间、发病率、死亡率及复发情况。

结果

在10年期间,本机构共有46例患者接受了直肠脱垂修复术。在39例原发性直肠脱垂患者中,18例接受了腹部手术,21例采用了经会阴入路。腹部手术的手术时间明显更长,其中16例为腹腔镜手术。两组之间的住院时间和复发率无统计学差异。在复发性直肠脱垂患者中,超过80%的初次手术采用经会阴入路。75%的复发患者采用腹部入路进行治疗。

结论

腹部修复术在复发性直肠脱垂的治疗中可能更可取。微创技术可能可行,并且可以为老年患者提供一种安全的替代会阴手术的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc1a/8980170/88b8eb3c5818/jmis-22-4-164f1.jpg

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