Berk G
Chirurg. 1979 Mar;50(3):173-9.
A series of 164 patients with procidentia recti has been studied. Symptoms are sensation of obstruction, difficulties in emptying the bowel, proctitis, incontinence, reduced tonus of anal sphincters, and complete rectal prolapse. During I the rectum prolapses only under increased intraabdominal pressure and retracts spontaneously. Massive prolapse (stage II) often occurs without increased intraabdominal pressure and has to be reposited manually. Best results are obtained by fixing the mobilised rectum in the hollow of the sacrum as described by Wells in 1959 or by Ripstein in 1969. In bad risk patients a sublevatoric wire can be used. Most patients have satisfactory continence postoperatively without a corresponding physiological tonus of anal sphincters.
对164例直肠脱垂患者进行了一系列研究。症状包括梗阻感、排便困难、直肠炎、失禁、肛门括约肌张力降低以及完全性直肠脱垂。在第一阶段,直肠仅在腹内压升高时脱垂,并可自行回缩。重度脱垂(II期)常无腹内压升高而发生,必须手动复位。按照1959年韦尔斯或1969年里普斯坦所描述的方法,将游离的直肠固定于骶骨凹陷处可获得最佳效果。对于高危患者,可使用肛提肌下钢丝。大多数患者术后控便情况良好,但肛门括约肌并无相应的生理张力。