圆形吻合器直肠黏膜环切术治疗直肠黏膜脱垂的疗效

Treatment of 18 patients with rectal mucosal prolapse using rectal mucosal sleeve resection by the circular stapler

目的 评价采用圆形吻合器治疗直肠黏膜脱垂的安全性和可行性。方法 回顾性分析 2 0 0 2年 10月至 2 0 0 4年 1月手术治疗的 18例直肠黏膜脱垂病人 ,均经排粪造影诊断。结果 18例中直肠黏膜内脱垂 8例 ;直肠黏膜外脱垂合并痔脱出 10例。手术时间 0 .3～ 1.0h (平均 0 .5 3h) ,吻合口距齿状线的距离 1.0～ 2 .5cm(平均 1.9cm )。黏膜切除上下平均宽度为 2 .5～ 3 .5cm。环切黏膜圈完整 15例 ;不完整 3例。术后随访 1月～ 12月 ,均对手术效果满意 ,直肠黏膜脱垂无复发 ,1例 6月后仍便血。结论 圆形痔吻合器经肛门直肠黏膜环切术是治疗直肠黏膜脱垂的有效方法 。

Objective To evaluate the safety and efficacy for rectal mucosal prolapse using a hemorrhoidal circular stapler device. Methods A total of 18 patients with rectal mucosal prolapse treated surgically from October 2002 to January 2004 were analyzed retrospectively. All the patients were diagnosed by defecography. Results Internal rectal mucosal prolapse was found in 8 patients and external rectal mucosal prolapse with prolapsed hemorrhoids in 10 patients out of the 18 patients. The operation time ranged from 0.3 to 1.0 h (averaging 0.53 h). The distance of the anastomosis from the dentate line ranged from 1.0 to 2.5 cm (averaging 1.9 cm). The average width of the resected mucous membrane ranged from 2.5 to 3.5 cm. Complete rectal mucosal sleeve resection was performed in 15 cases, but incomplete in 3 cases. The follow up (1-12 months) showed satisfactory surgical outcomes and no recurrence of prolapse in all cases. Rectal bleeding occurred in 1 case 6 months after operation. Conclusion The transanal rectal mucosal sleeve resection by a stapler device is a safe, easy, and effective surgical method for rectal mucosal prolapse.