Lehur P A, Guiberteau-Canfrère V, Bruley des Varannes S, Moyon J, Le Borgne J
Clinique Chirurgicale II, Hôpital Laennec, Nantes.
Gastroenterol Clin Biol. 1996 Mar;20(2):172-7.
Various options have been suggested to improve the functional results of abdominal rectopexy for rectal prolapse and to limit the risk of post-operative constipation.
In this prospective study, we evaluated the results of posterior abdominal rectopexy-sigmoidectomy to treat rectal prolapse syndrome in terms of morbidity, anatomic correction and bowel function. Patient benefits after surgery were assessed according to their pre-operative functional status.
Twenty patients (14 females, mean age: 42 years) were treated for rectal prolapse with sutured abdominal rectopexy and sigmoidectomy.
(a) Thirteen patients had normal post-operative course. No anastomotic leak occurred. Mean hospital stay was 9.7 days. (b) Anatomical control was obtained in all cases for a mean follow-up of 31.2 months without recurrence. (c) Functional results: bowel movements per week remained unchanged pre- and post-operatively (18.6 +/- 33 vs 18.1 +/- 17). Constipation appeared or worsened in 2 patients (10%). Anal incontinence (n = 6-30%) never worsened post-operatively and improved in 3.
This prospective clinical study confirmed the important functional disorders occurring in rectal prolapse syndrome. Rectopexy-sigmoidectomy is a valid option with stable mid-term results. Constipation was observed in 10% with no worsening of anal incontinence.
已经提出了各种方法来改善直肠脱垂腹部直肠固定术的功能效果，并降低术后便秘的风险。
在这项前瞻性研究中，我们从发病率、解剖学矫正和肠道功能方面评估了后位腹部直肠固定术-乙状结肠切除术治疗直肠脱垂综合征的效果。根据患者术前的功能状态评估术后的获益情况。
20例患者（14例女性，平均年龄：42岁）接受了缝合式腹部直肠固定术和乙状结肠切除术治疗直肠脱垂。
（a）13例患者术后病程正常。未发生吻合口漏。平均住院时间为9.7天。（b）所有病例均获得解剖学控制，平均随访31.2个月无复发。（c）功能结果：术前和术后每周排便次数保持不变（18.6±33次对18.1±17次）。2例患者（10%）出现便秘或便秘加重。肛门失禁（n = 6 - 30%）术后从未加重，3例有所改善。
这项前瞻性临床研究证实了直肠脱垂综合征中存在的重要功能障碍。直肠固定术-乙状结肠切除术是一种有效的选择，中期结果稳定。观察到10%的患者出现便秘，肛门失禁未加重。
