环形吻合器经肛门直肠切除术治疗直肠脱垂:一项前瞻性队列研究

A. Porwal, P. Gandhi, D. Kulkarni
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引用次数: 0

摘要

背景:直肠脱垂手术旨在纠正病情,改善失禁,预防便秘。目前的治疗方法存在问题,但作者开发了TRRPCS,这是一种有效解决直肠脱垂和相关功能问题的创新方法。设计:观察性前瞻性研究。目的:探讨环形吻合器经肛门直肠脱垂切除术(TRRPCS)的疗效和远期疗效。设置:单中心。患者和方法:所有受试者均接受环形吻合器经肛门直肠切除术治疗脱垂。患者已被随访两年,电话随访计划为五年。主要转归指标:获得术前和术后ODS评分和Wexner大便失禁评分,以评估症状转归。Longo ODS评分系统的改进、Wexner大便失禁评分和患者的主观总体满意度用于评估。样本量:91。结果:在一项针对91名患者(年龄41-60岁)的研究中,TRRCS手术的中位手术时间为40分钟,中位住院时间为24小时。正常活动在5天内恢复。并发症包括疼痛、烧灼感、紧迫感、出血和松动。Longo和Wexner评分有显著改善。78.85%的患者表示高度满意。一名患者出现粘膜脱垂,治疗成功。在长达七年的随访中,没有其他复发报告。结论:TRRPCS:安全、微创的日托程序可改善失禁,纠正便秘,无性功能障碍。复发率低(1.1%),长期随访。局限性:单一机构,非比较数据。利益冲突:未宣布利益冲突。
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Transanal rectal resection by circular stapler for rectal prolapse: A prospective cohort study
Background: Rectal prolapse surgery aims to correct the condition, improve continence, and prevent constipation. Current treatments have issues, but the author developed TRRPCS, an innovative approach to effectively address rectal prolapse and associated functional issues. Design: Observational prospective study. Objective: To explore effectiveness and long term outcomes of TRRPCS (Trans-anal Rectal Resection of Prolapse by Circular Stapler). Settings: Single centre. Patients and Methods: All subjects underwent Transanal Rectal Resection by Circular stapler for prolapse. Patients have been followed for two years and telephonic follow-up was planned for five years. Main Outcome Measures: Pre and postoperative ODS scores and Wexner fecal incontinence score were obtained to evaluate symptomatic outcomes. Improvement in Longo's ODS score system, Wexner fecal incontinence score and subjective overall satisfaction of patients were used for evaluation. Sample Size: 91. Results: In a study of 91 patients (aged 41-60), TRRCS procedure had a median surgery time of 40 minutes and a median hospital stay of 24 hours. Normal activities resumed within 5 days. Complications included pain, burning, urgency, bleeding, and loose motions. Significant improvement was observed in Longo and Wexner scores. 78.85% of patients were highly satisfied. One patient experienced mucosal prolapse, treated successfully. No other recurrences were reported during a follow-up of up to seven years. Conclusion: TRRPCS: Safe, minimally invasive daycare procedure improves incontinence, corrects constipation without sexual dysfunction. Low recurrence rate (1.1%) with long-term follow-up. Limitations: Single institution, Non comparative data. Conflict of Interest: No conflict of interest declared.
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