腹腔镜下与开放式腹部直肠切除术治疗完全性直肠脱垂的疗效——我们在Bangabandhu Sheikh Mujib医科大学的经验

K. N. Naznin, S. H. Sheikh, A. Habib, Rashidul Lslam, A. Alam, G. Salahuddin, R. Rahman
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引用次数: 0

摘要

背景:完全性直肠脱垂是一种非常痛苦的疾病。在成人中,唯一可能治愈的治疗完全直肠脱垂的方法是经腹或会阴手术!方法。迄今为止,腹部直肠固定术被认为是治疗完全性直肠脱垂的标准手术方法,可以通过腹腔镜或开放手术进行。目的:通过主观评价,观察腹腔镜直肠固定术治疗完全性直肠脱垂的效果,并与常规开腹直肠固定术的效果进行比较。方法:该随机临床试验于2012年7月至2014年6月在达卡Bangabandhu Sheikh Mujib医科大学外科进行,为期24(24)个月。年龄在25至70岁之间,不分性别,表现为完全性直肠脱垂的患者被选为研究人群。采用抽签法将患者随机分为两组:I组采用腹腔镜直肠固定术(LR), II组采用开放式直肠固定术(OR)。结果:本研究共招募了50例患者,其中25例患者。1组25例,2组25例。I组和II组患者的平均(s.d)年龄分别为49.40(13.22)岁和46.48(13.27)岁(p>0.05)。I组平均手术时间为115(19)min, II组平均手术时间为75(12)min (p < 0.05)。组平均(s.d)下床时间分别为1.96(0.67)天和3.92(1.15)天(p0.05)。结论:腹腔镜直肠固定术是治疗完全性直肠脱垂的较好方法。外科杂志(2015)Vol. 19 (1): 3-7
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Outcome of Laparoscopic Versus Open Abdominal Rectopexy for the Treatment of Complete Rectal Prolapse-Our experience in Bangabandhu Sheikh Mujib Medical University
Background: Complete rectal prolapse is a very distressing condition. In adults, the only potentially curative treatment for complete rectal prolapse is surgery either by transabdominal or perinea! approaches. Till date abdominal rectopexy is considered as the standard surgical treatment for complete rectal prolapse, which can be done laparoscopically or by open procedure. Objective: The purpose of the study was to observe the outcome of Laparoscopic rectopexy in the treatment of complete rectal prolapse by subjective assessment and to compare the result with that of conventional open abdominal rectopexy. Methodology: This randomized clinical trial was carried out in the Department of Surgery at Bangabandhu Sheikh Mujib Medical University, Dhaka, from July 2012 to June 2014 for a period of twenty four (24) months. Patients who presented with complete rectal prolapse with age ranging from 25 to 70 years irrespective of gender were selected as study population. Patients were randomized by lottery method into two groups as group I who underwent laparoscopic rectopexy (LR) and group II who underwent open rectopexy (OR). Result: A total number of 50 patients were recruited in this study of which 25 patients were. in group I and 25 patients were in group II. The mean (s.d.) age was 49.40 (13.22) years and 46.48(13.27) years in group I and group II respectively (p>0.05). The mean (s.d.) operative time was 115(19) minutes in group I and 75(12) minutes in group II (p<0.05). In this study 1(4.0%) patient and 6 (24.0%) patients had abdominal wound infection in group I and in group II respectively (p>0.05). Mean (s.d.) ambulation time was 1.96 (0.67) days in group I and 3.92(1.15) days in groups II (p<0.05). Postoperative hospital stay mean (s.d.) was 3.08(1.18) days in group I and 8.16(3.57) days in group II (p<0.05). Overall patients satisfaction were 92% and 76% in group I and group II respectively (p>0.05). Conclusion: Laparoscopic rectopexy is a better option than conventional open abdominal rectopexy for the treatment of complete rectal prolapse. Journal of Surgical Sciences (2015) Vol. 19 (1) : 3-7
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