腹腔镜缝合直肠外翻术治疗全层直肠脱垂的短期疗效

Kareem Kamel, Ahmad Mamdouh Kelany, Tarek Youssef Ahmed, Ahmed Aly Khalil
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摘要

背景:全层直肠脱垂是一种使人衰弱的疾病,主要通过手术治疗。作为直肠脱垂的手术治疗方法,已有各种腹部和会阴部手术的报道。最近,腹腔镜缝合直肠外翻术作为治疗直肠脱垂的首选手术技术得到了广泛认可。本研究旨在评估腹腔镜下缝合直肠脱垂术治疗全厚性直肠脱垂(FTRP)的短期疗效。患者和方法:这是一项回顾性观察研究,评估腹腔镜直肠缝合术术后6个月内的术后复发、排便功能、便秘和失禁、性功能和总体满意度。研究对象包括艾因-沙姆斯大学医院在2021年1月至2022年12月期间收治的31名患有完全性直肠脱垂的成年患者,由同一个手术团队进行手术。研究结果在接受腹腔镜缝合直肠切除术的 31 名患者中,只有一例患者完全复发,没有性功能障碍的报告。19例患者出现便秘,其中7例完全缓解,9例明显好转,3例无变化。根据韦克斯纳评分,11 名患者出现尿失禁,其中 7 人完全康复,另外 4 人有所改善。结论对于全层直肠脱垂,腹腔镜缝合直肠切除术是一种安全的手术,复发率低,短期随访期间功能效果良好。
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Short-term outcomes of laparoscopic suture rectopexy in the treatment of full-thickness rectal prolapse
Background: Full-thickness rectal prolapse is a debilitating disease that is treated mainly surgically. Various abdominal and perineal procedures have been reported as a surgical treatment for rectal prolapse. Suture rectopexy by the laparoscopic approach has recently gained acceptance as a favored surgical technique for rectal prolapse treatment. This study aims to evaluate the short-term outcomes of laparoscopic suture rectopexy performed for full-thickness rectal prolapse (FTRP). Patients and Methods: This is a retrospective observational study evaluating laparoscopic suture rectopexy as regards postoperative recurrence, bowel function, constipation and incontinence, sexual function, and overall satisfaction in a 6-month duration after surgery. The study included 31 adult patients admitted at Ain-Shams University Hospitals with complete rectal prolapse operated by the same surgical team between January 2021 and December 2022. Results: Out of 31 patients who underwent laparoscopic suture rectopexy, one case only had a complete recurrence, no sexual disorders had been reported. Nineteen patients presented with constipation; seven of them had complete resolution, nine were significantly improved; however, three patients had no change. Eleven patients presented with incontinence, seven had complete resolution, and the other four were improved according to the Wexner score. Conclusion: For full-thickness rectal prolapse, laparoscopic suture rectopexy is a safe procedure with a low recurrence rate and good functional results during the short-term follow-up.
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