Senapati A, Nicholls R J, Thomson J P, Phillips R K
St. Mark's Hospital, London, United Kingdom.
Dis Colon Rectum. 1994 May;37(5):456-60. doi: 10.1007/BF02076191.
This study was designed to examine the results of Delorme's procedure.
Thirty-two patients (24 males and 8 females, mean age, 70 years) underwent Delorme's procedure between 1978 and 1990 following symptoms lasting between two weeks and ten years. Thirteen patients had had 21 previous operations for prolapse.
The mean operation time was 65 minutes. No blood transfusions were needed, there was no operative mortality, and only two patients had complications (one chest infection and one anastomotic dehiscence). No patients were lost to follow-up. Over a mean follow-up of 24 months (4 months to 4 years), 9 patients died of unrelated conditions. There were four recurrences (12.5 percent), two in patients who had each had two previous procedures. Incontinence improved in 46 percent. No patient became constipated and 50 percent of those constipated preoperatively improved.
Although abdominal rectopexy is safe and has a low recurrence rate (< 5 percent), it involves the hazards of a laparotomy. In addition, up to 40 percent of patients become constipated after rectopexy which may be debilitating. Delorme's procedure has a low morbidity, results in good bowel function, and has a low recurrence rate. It can be performed on unfit patients with possible advantages over rectopexy and perhaps should be used more readily.
本研究旨在探讨德洛姆手术的结果。
1978年至1990年间，32例患者（24例男性，8例女性，平均年龄70岁）在出现持续两周至十年的症状后接受了德洛姆手术。13例患者此前因直肠脱垂接受过21次手术。
平均手术时间为65分钟。无需输血，无手术死亡病例，仅2例患者出现并发症（1例肺部感染和1例吻合口裂开）。无患者失访。平均随访24个月（4个月至4年），9例患者死于无关疾病。有4例复发（12.5%），其中2例患者此前各接受过两次手术。46%的患者失禁情况有所改善。无患者出现便秘，术前便秘的患者中有50%情况得到改善。
尽管腹直肌固定术安全且复发率低（<5%），但它存在剖腹手术的风险。此外，高达40%的患者在直肠固定术后会出现便秘，这可能会使人虚弱。德洛姆手术发病率低，肠道功能良好，复发率低。它可用于身体状况不佳的患者，可能比直肠固定术更具优势，或许应更广泛地应用。
