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改良腹腔镜缝合直肠固定术治疗直肠脱垂的安全性和有效性评估

Evaluation of the Safety and Efficacy of Modified Laparoscopic Suture Rectopexy for Rectal Prolapse.

作者信息

Takahashi Rina, Yamana Tetsuo, Nishio Risa, Sakamoto Kazuhiro, Nojiri Shuko, Sugimoto Kiichi

机构信息

Department of Coloproctology, Tokyo Yamate Medical Center, Tokyo, Japan.

Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan.

出版信息

J Anus Rectum Colon. 2023 Apr 25;7(2):102-108. doi: 10.23922/jarc.2022-049. eCollection 2023.

Abstract

OBJECTIVES

There are many surgical options for the treatment of rectal prolapse. To date, the efficacy of mesh-free laparoscopic suture rectopexy remains unclear due to the limited number of reports. This study aimed to evaluate the safety and efficacy of laparoscopic suture rectopexy.

METHODS

This observational cohort study is a retrospective cross-sectional analysis of a continuously maintained database. All patients underwent laparoscopic suture rectopexy for rectal prolapse between April 2012 and March 2018. The primary outcomes measured were recurrence rates and complications of laparoscopic suture rectopexy.

RESULTS

A total of 268 patients (29 male and 239 female) underwent laparoscopic suture rectopexy. Their mean age was 77 (19-95) years, and the mean prolapse length was 6.4 (3.5-20) cm. One patient suffered an intraabdominal abscess. Spondylitis developed in another patient following surgery. The median follow-up period was 45 (12-82) months. A total of 22 patients (8.2%) developed recurrence. The average time to recurrence was 15.6 (1-44) months. Multivariate analysis revealed a significant correlation between recurrence and prolapse length >7.0 cm (OR: 1.26, 95% CI: 1.38-1.42, < 0.01).

CONCLUSIONS

Laparoscopic suture rectopexy for complete rectal prolapse is a minimally invasive and safe procedure that may lead to lower recurrence rates.

摘要

目的

治疗直肠脱垂有多种手术选择。迄今为止,由于报告数量有限,无网片腹腔镜缝合直肠固定术的疗效尚不清楚。本研究旨在评估腹腔镜缝合直肠固定术的安全性和疗效。

方法

本观察性队列研究是对一个持续维护的数据库进行的回顾性横断面分析。2012年4月至2018年3月期间,所有患者均接受了腹腔镜缝合直肠固定术治疗直肠脱垂。测量的主要结局是腹腔镜缝合直肠固定术的复发率和并发症。

结果

共有268例患者(29例男性和239例女性)接受了腹腔镜缝合直肠固定术。他们的平均年龄为77(19 - 95)岁,平均脱垂长度为6.4(3.5 - 20)厘米。1例患者发生腹腔内脓肿。另1例患者术后发生脊柱炎。中位随访期为45(12 - 82)个月。共有22例患者(8.2%)复发。复发的平均时间为15.6(1 - 44)个月。多变量分析显示复发与脱垂长度>7.0厘米之间存在显著相关性(OR:1.26,95%CI:1.38 - 1.42,<0.01)。

结论

腹腔镜缝合直肠固定术治疗完全性直肠脱垂是一种微创且安全的手术,可能导致较低的复发率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db2a/10129356/810294e2a9bd/2432-3853-7-0102-g001.jpg

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