Buchmann P, Keighley M R
Schweiz Med Wochenschr. 1982 May 1;112(18):648-52.
Many patients with rectal prolapse and/or fecal incontinence could be helped if they disclosed the ailment to their physician. Thirteen out of 23 patients underwent transabdominal rectopexy and remained recurrence-free, whereas only one out of 10 anal cerclages brought relief of symptoms. Simultaneous incontinence was also eliminated in most cases by rectopexy. Thirty-one patients with incontinence in the absence of traumatic sphincter lesions or urgency grade 2 were treated either by voluntary training of the pelvic floor muscles in combination with faradic stimulation, or by postanal repair. Fifteen patients regained continence or showed some improvement. Thirteen of the remaining 16 patients were healed or improved after postanal repair. The authors therefore recommend transabdominal rectopexy for rectal prolapse. In cases of simultaneous incontinence the rectopexy should be performed first. If a course of training of the pelvic floor muscles produces no improvement, postanal repair is advisable.
如果患有直肠脱垂和/或大便失禁的患者向医生透露病情，许多患者可能会得到帮助。23名患者中有13名接受了经腹直肠固定术，且未复发，而10例肛门环扎术中只有1例症状得到缓解。在大多数情况下，直肠固定术还消除了同时存在的失禁症状。31例无创伤性括约肌损伤或急迫性2级的失禁患者，要么通过盆底肌肉自主训练结合感应电刺激进行治疗，要么通过肛门后修复术进行治疗。15名患者恢复了控便能力或有一定改善。其余16名患者中有13名在肛门后修复术后治愈或病情改善。因此，作者建议对直肠脱垂采用经腹直肠固定术。对于同时存在失禁的情况，应首先进行直肠固定术。如果盆底肌肉训练疗程没有改善，建议进行肛门后修复术。
