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经肛吻合器直肠切除术治疗出口梗阻型便秘的并发症分析 被引量:11

Complications after stapled transanal rectal resection for obstructed defecation
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摘要 目的评价经肛吻合器直肠切除术(STARR)治疗出口梗阻型便秘(ODS)的安全性。方法回顾性分析2007年1月至2008年10月间第二炮兵总医院采用STARR治疗112例直肠前突和(或)直肠内套叠相关性ODS女性病例的临床资料.统计围手术期及术后远期并发症发生情况。结果术后早期发生并发症18例(16.1%),包括肛门失禁(4.5%)、吻合口出血(2.7%)、吻合口部分裂开(0.9%)、肛裂(2.7%)、急性尿潴留(1.8%)、血栓性外痔(1.8%)、直肠阴道隔血肿(0.9%)、粪便嵌塞(0.9%),其中2例患者(1.8%)因并发症需再次手术干预。术后中位随访24个月,远期发生并发症6例(5.4%),包括:肛门失禁(1.8%)、排粪急迫感(0.9%)、吻合口周围炎致慢性疼痛(1.8%)、直肠憩室致慢性疼痛(0.9%),其中3例患者(2.7%)需手术治疗。结论STARR是治疗出口梗阻型便秘相对安全的术式。 Objective To evaluate the safety of stapled transanal rectal resection (STARR) for the treatment of obstructed defecation syndrome (ODS). Methods A retrospective study was performed in 112 female patients with ODS eligible for STARR. The short-lerm and long-term postoperative complications were recorded and assessed. Results Short-term postoperative complications and adverse events were reported in 18 patients ( 16.1% ) including fecal incontinence (4.5 % ), anastomotic bleeding (2.7%), staple line partial dehiscence (0.9%), anal fissure (2.7%), acute urinary retention(1.8%), thrombosed external hemorrhoid(1.8%), hematoma of the rectovaginal septum (0.9%) and fecal impaction (0.9%). Reoperation was required in 2 patients (1.8%)due to the short-term postoperative complications. The median length of follow-up was 24 months. There were 6 patients with long-term postoperative complications (5.4%) including fecal incontinence (1.8%), defecatory urgency (0.9%), chronic pain due to anastomotic inflammation (1.8%), and chronic pain due to anal rectal diverticulum(0.9%). Three patients(2.7%) were reoperated. Conclusion STARR appears to be a safe technique for patients with obstructed defecation.
出处 《中华胃肠外科杂志》 CAS 北大核心 2011年第12期934-937,共4页 Chinese Journal of Gastrointestinal Surgery
基金 北京市科委课题“首都临床特色应用研究”(Z111107058811051)
关键词 经肛吻合器直肠切除术 出口梗阻型便秘 直肠前突 直肠内套叠 Stapled transanal rectal resection Obstructed defecation syndrome Rectocele Rectal intussusception
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  • 1Pescatori M, Spyrou M, Pulvirenti d'Urso A. A prospective evaluation of occult disorders in obstructed defecation using the iceberg diagram . Coloreetal Dis, 2007, 9(5) :452-456.
  • 2Corman ML, Carriero A, Hager T, et al. Consensus conferenceon the stapled transanal rectal resection (STARR) for disordered defaecation. Colorectal Dis, 2006,8 (2) : 98- 101.
  • 3Sciaudone G, Di Stazio C, Guadagni I, et al. Rectal diverticulum: a new complication of STARR procedure for obstructed defecation. Tech Coloproctol, 2007,30:1-3.
  • 4Li Destri G, Scilletta B, Tomaselli TG, et al. Rectovaginal fistula: a new approach by stapled transanal rectal resection. J Gastrointest Surg, 2008,12(3) :601-603.
  • 5Gagliardi G, Pescatori M, Ahomare DF, et al. Results, outcome predictors, and complications after stapled transanal rectal resection for obstructed defecation. Dis Colon Rectum, 2008,51 (2) : 186-195.

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