Department of Surgery, NHO Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-Ku, Osaka City, Osaka, 540-0006, Japan.
Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamada-Oka, Suita City, Osaka, 565-0871, Japan.
BMC Surg. 2024 Sep 3;24(1):246. doi: 10.1186/s12893-024-02545-6.
Laparoscopic rectopexy is an established treatment option for full-thickness rectal prolapse. Recently, reduced port surgery (RPS) has emerged as a novel concept, offering reduced postoperative pain and improved cosmetic outcomes compared with conventional multiport surgery (MPS). This study aimed to evaluate the feasibility and safety of RPS for full-thickness rectal prolapse.
From October 2012 to December 2018, 37 patients (MPS: 10 cases, RPS: 27 cases) underwent laparoscopic rectopexy for full-thickness rectal prolapse. Laparoscopic posterior mesh rectopexy (Wells procedure) is the standard technique for full-thickness rectal prolapse at our hospital. RPS was performed using a multi-channel access device, with an additional 12-mm right-hand port. Short-term outcomes were retrospectively compared between MPS and RPS.
No significant differences were observed between MPS and RPS in the median operative time, the median blood loss volume, the postoperative complication rates, and median hospital stay duration after surgery.
Reduced port laparoscopic posterior mesh rectopexy may serve as an effective therapeutic option for full-thickness rectal prolapse. However, to establish the superiority of RPS over MPS, a prospective, randomized, controlled trial is warranted.
腹腔镜直肠固定术是全层直肠脱垂的一种既定治疗选择。最近,减少端口手术(RPS)已经成为一种新的概念,与传统的多端口手术(MPS)相比,它具有术后疼痛减轻和美容效果改善的优势。本研究旨在评估 RPS 治疗全层直肠脱垂的可行性和安全性。
从 2012 年 10 月至 2018 年 12 月,37 例患者(MPS:10 例,RPS:27 例)接受腹腔镜全层直肠脱垂直肠固定术。腹腔镜后网片直肠固定术(威尔斯手术)是我院治疗全层直肠脱垂的标准技术。RPS 使用多通道接入装置进行,另外增加 12mm 右手端口。回顾性比较 MPS 和 RPS 的短期结果。
MPS 和 RPS 在手术时间中位数、术中出血量中位数、术后并发症发生率和术后住院时间中位数方面无显著差异。
减少端口腹腔镜后网片直肠固定术可能是全层直肠脱垂的有效治疗选择。然而,为了确立 RPS 优于 MPS 的优势,需要进行前瞻性、随机、对照试验。