前列腺电切系统治疗重度良性直肠狭窄

Transurethral Prostatic Resection for Treatment of Severe Cases of Benign Rectal Stricture

目的探讨前列腺电切系统治疗重度良性直肠狭窄的可行性和疗效。方法2001年2月～2008年1月使用CyrusMedical经尿道等离子体双极电切系统和电切镜监视摄像系统进行手术。将F24内鞘置入肛管后冲洗肛管，观察狭窄段的长度和直径，注水扩张狭窄段以上肠管，切除2～10点位的狭窄段，10—2点狭窄段少量切除。结果18例手术均成功。手术时间40—110min，平均72min。术中出血量10～90ml，平均53ml。术后肛门排气时间10-35h，平均17h。术后住院时间4～7d，平均6d。16例随访6～60个月，平均39个月，14例经一次手术治愈，2例术后复发，其中1例经再次采用该手术后治愈，1例共经3次该手术好转。结论前列腺电切系统治疗重度良性直肠狭窄安全可靠，疗效确切。

Objective To explore the feasibility and efficacy of transurethral prostatic resection （TURP） for treatment of severe cases of benign rectal stricture （BRS）. Methods From February 2001 to January 2008, 18 severe cases of BRS were treated in our hospital by. using the Cyrus Medical. After placing a F24 sheath in the anal duct for washing, we observed the length and diameter of the strictured segment. Afterwards, dilatation of the recta above the rectal stricture was carried out by affusing 0.9% NaCl. The strictured segment was then resccted completely between the 2 - 10 clocks, and removed partly from the 10 to 2 clock. Results The operation was completed successfully in all the patients with a mean operation time of 72 min （40 - 110 min）. The intraoperative blood loss ranged from 10 to 90 ml （mean, 53 ml）. The gastrointestinal function recovered in 10 -35 hours （mean, 17 hours）, and the patients were discharged from the hospital in 4 to 7 days （ mean 6 days）. A 6- to 60-month follow-up was completed in 16 of the patients （mean, 39 months） , during which 14 patients were cured and 2 had recurrence; one of the recurrent cases was cured by a second operation, and the other recovered after anther three surgeries. Conclusion TURP is a feasible and safe treatment for severe cases of BRS.