Delaini G G, Scaglia M, Hulten L
Istituto di Patologia Chirurgica, Cattedra di Chirurgia Generale, Università di Verona.
Ann Ital Chir. 1994 Mar-Apr;65(2):183-7.
21 patients (19 women) who underwent rectal prolapse repair were prospectively studied. At the one year follow-up, 6 of the eleven incontinent patients (54 per cent) regained full continence and while three of the remaining 5 patients improved they still referred occasional imperfection of continence. Resting anal pressure and maximal squeeze pressure were both significantly lower in the five patients who remained incontinent, 23 (17-31) mm Hg vs 50 (31-52) mm Hg (p < = 0.02) and 52 (17-75) mm Hg vs 108 (89-110) mm Hg (p < = 0.02), respectively. Moreover the manometric results showed evidence that in patients who remained incontinent, the anal pressure in response to rectal distention, was significantly lower than patients who regained continence (p < = 0.05) both before and after operation. We conclude that incontinent patients with rectal prolapse who exhibit a markedly low minimal residual anal pressure on recto-anal reflex inhibition are less likely to improve after rectopexy and that this preoperative test may be a useful predictor.
对21例行直肠脱垂修复术的患者（19名女性）进行了前瞻性研究。在一年的随访中，11名失禁患者中有6名（54%）恢复了完全控便，其余5名患者中有3名情况有所改善，但仍偶尔存在控便不完全的情况。5名仍失禁的患者静息肛管压力和最大收缩压力均显著较低，分别为23（17 - 31）mmHg对比50（31 - 52）mmHg（p <= 0.02）和52（17 - 75）mmHg对比108（89 - 110）mmHg（p <= 0.02）。此外，测压结果表明，仍失禁的患者在直肠扩张时的肛管压力在术前和术后均显著低于恢复控便的患者（p <= 0.05）。我们得出结论，直肠脱垂失禁患者若在直肠 - 肛门反射抑制时表现出明显低的最小残余肛管压力，则直肠固定术后改善的可能性较小，且该术前检查可能是一个有用的预测指标。
