摘要
目的探讨腹腔镜直肠腹侧固定术治疗直肠脱垂的临床应用价值。方法回顾性分析2013年1月至2017年1月山西省人民医院手术治疗的26例完全性直肠脱垂患者,对照组15例采用腹腔镜直肠后固定术,研究组11例采用腹腔镜直肠腹侧固定术。结果两组患者的手术时间、术中出血量、术后排气时间差异均无统计学意义(t=1.839,0.138,0.932,均P>0.05)。研究组有2例出现术后发热2d,自行好转。随访12~36个月,对照组和研究组各有1例复发,直肠脱出长度约2cm。对照组伴有便秘的7例患者中2例便秘症状消失,2例症状好转,另有5例新出现便秘;伴有肛门失禁的4例患者中2例治愈,1例症状改善;伴有中盆脱出的3例患者无明显变化。研究组伴有便秘的6例患者中3例便秘症状消失,2例症状好转,未再出现新的便秘患者;伴有肛门失禁的3例患者中2例治愈,1例症状改善;伴有中盆脱出的3例患者中2例痊愈,1例好转。研究组术后中盆脱出和便秘程度较对照组轻,差异有统计学意义(χ2=4.909,P<0.05)。结论腹腔镜直肠腹侧固定术治疗完全性直肠脱垂并发症少、复发率低,对于术前存在便秘和中盆脱出的患者更加适用。
Objective To explore the clinical value of laparoscopic ventral rectopexy for rectal prolapse. Methods From Jan 2013 to Jan 2017,26 patients with complete rectal prolapse were divided into control group (15 patients) undergoing laparoscopic rectal fixation,and 11 patients in study group were treated with rectal ventral fixation. Results There was no significant difference in operation time,bleeding volume and exhaust time between the two groups (t=1.839,0.138,0.932,all P>0.05).In the study group,2 cases had temporarily postoperative fever.Following up for 12 to 36 months,1 case recurred in the control group and 1 case in the study group.The length of rectal prolapse was about 2 cm.Of the 7 patients with constipation in the control group,symptoms disappeared in 2 cases,symptoms improved in another 2 cases,and 5 cases had new constipation.Of the 4 patients with anal incontinence,2 cases had recovered and 1 case had symptoms improved.Among the 6 patients with constipation in the study group,symptoms disappeared in 3 cases,symptoms improved in 2 cases.Of the 3 patients with pelvic prolapse,2 cases recovered and 1 case improved.The pelvic prolapse and constipation in the study group was less severe than that in the control group (χ2=4.909,P<0.05). Conclusion Laparoscopic rectal ventral fixation for the treatment of complete rectal prolapse is less traumatic,safor and more effective.
作者
牛丽云
田利军
杨建永
唐劲
李奇
贺强
黄敬
翟春宝
Niu Liyun;Tian Lijun;Yang Jianyong;Tang Jin;Li Qi;He Qiang;Huang Jing;Zhai Chunbao(Department of Colorectal and Anal Surgery,Shanxi People′s Hospital,Taiyuan 030012,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2019年第1期35-38,共4页
Chinese Journal of General Surgery
