经会阴横切口横缝肛提肌治疗直肠前突性功能性便秘

Transverse Suture of Musculi Levator Ani via Transverse Perineal Incision for Functional Constipation Caused by Rectocele

目的 探讨经会阴横切横缝法治疗直肠前突性功能性便秘的疗效。方法 2011年9月～2013年3月，选取菏泽家政职业学院附属医院直肠前突性功能性便秘38例，采用会阴部横行切口，钝性分离直肠阴道隔，7号线横行缝合两侧肛提肌。结果 手术时间23～40min，平均28min；术中出血8～35ml，平均15ml；术后疼痛I度35例，Ⅱ度3例；肛门坠胀感36例；住院时间6～10d，平均8d。术后随访时间7～12个月，便秘治愈36例，好转2例。结论 经会阴入路横行缝合法治疗直肠前突性功能性便秘疗效肯定，手术安全。

Objective To investigate the effect of transverse suture of musculi levator ani via transverse perineal incision for functional constipation caused by rectocele. Methods From September 2011 to March 2013, 38 cases of functional constipation caused by rectocele were selected. Patients received transverse incision of perineum, blunt separation of rectovaginal septum, transverse suture of both sides of musculi levator ani with 7^# suture. Results Operative time was 23 - 40 min, with an average of 28 min; intraoperative blood loss was 8 -35 ml, with an average of 15 ml; postoperative pain included 35 cases of grade I and 3 cases of grade Ⅱ ; anal bulge was found in 36 cases; hospital stay was 6 - 10 d, with an average of 8 d. All cases were followed up for 7 - 12 months, 36 cases were cured and 2 cases improved. Conclusion Perineal approach transverse suture of musculi levator ani is safe and effective for the treatment of functional constipation caused by rectocele.