Lazorthes F, Gamagami R, Cabarrot P, Muhammad S
Department of General and Digestive Surgery, University of Toulouse III, Purpan Hospital, France.
Dis Colon Rectum. 1998 May;41(5):602-5. doi: 10.1007/BF02235267.
The cause of rectal intussusception in patients primarily dominated by symptoms of anal incontinence has not been fully elucidated, especially for patients with idiopathic incontinence.
Between 1991 and 1996, 51 patients referred with a diagnosis of idiopathic incontinence were prospectively evaluated by standard questionnaire, clinical examination, defecography, and anal manometry. Fourteen female patients were identified with rectal intussusception and were treated by transabdominal rectopexy. Postoperatively, clinical assessment and anal manometry were performed at regular intervals.
Continence was improved after rectopexy (P < 0.01). The postoperative increases in the anal resting pressure, maximum squeeze pressure, and maximum tolerated volume were not statistically significant.
Rectopexy improved anal incontinence in patients with rectal intussusception. The cause of rectal intussusception in anal incontinence could not be explained by functional improvement of the internal anal sphincter tone or an increase in the maximum tolerated volume. Rectal intussusception may be a cause of idiopathic incontinence in patients; however, larger prospective studies are required to support this concept.
以肛门失禁症状为主的患者发生直肠套叠的原因尚未完全阐明，尤其是特发性失禁患者。
1991年至1996年间，对51例诊断为特发性失禁的患者进行前瞻性评估，采用标准问卷、临床检查、排粪造影和肛门测压法。确定14例女性患者有直肠套叠，并接受经腹直肠固定术治疗。术后定期进行临床评估和肛门测压。
直肠固定术后控便能力得到改善（P<0.01）。术后肛门静息压、最大挤压压和最大耐受容量的增加无统计学意义。
直肠固定术改善了直肠套叠患者的肛门失禁。肛门失禁患者发生直肠套叠的原因无法用肛门内括约肌张力的功能改善或最大耐受容量的增加来解释。直肠套叠可能是患者特发性失禁的一个原因；然而，需要更大规模的前瞻性研究来支持这一概念。
