Delorme手术治疗21例完全性直肠脱垂的效果观察

Delorme's procedure for complete rectal prolapse: effects and outcomes of 21 cases

目的本研究旨在观察Delorme术式对完全性直肠脱垂的治疗效果,以探讨Delorme术用于治疗完全性直肠脱垂的可行性。方法选取新疆维吾尔自治区人民医院胃肠外科2006-2010年间行Delorme手术的完全性直肠脱垂患者21例,其中女性14例,男性7例。采用Wexner排便失禁评分以及肛门压力检测法对患者术前和术后的排便情况进行比较。结果21例患者在手术前均存在对稀水便、固体便以及排气失禁的情况。术后4例患者分别于第6,8,12,18个月时出现病情复发,占总人数的19.0%。术后失访患者2例,在余下的19例患者中,15例(78.9%)排便失禁有不同程度的改善,其中8例(42.1%)明显改善,7例(36.8%)完全治愈,其余4例(21.1%)效果不明显;有1例(5.3%)术前未诉便秘,但术后却出现便秘。结论 Delorme手术用于治疗完全性直肠脱垂具有疗效确切、并发症少、术后便秘发生率低等特点,其在直肠脱垂的治疗中具有重要价值。

Objective To evaluate the clinical outcomes of the Delorme＇ s procedure in the treatment of the complete rectal prolapse. Methods Twenty-one patients with complete rectal prolapse from 2006 to 2010 in our hospital were collected. The status of defeca- tion was evaluated before and after surgery by Wexner score and anal manometry. Results Before operation,all 21 patients had in- continence to liquid stool, solid stool, and/or flatus. Four patients（ 19.0% ） had recurrence of rectal prolapse at 6th,8th, 12th and 18th month respectively. The information of 2 patients was missed. Of 19 cases, 15 （78.9%） were improved in anal incontinence to varying degrees, including 8 （42.1% ）of significantly improved and 7 （36.8%）of completely cured. Symptoms of 4 patients were just improved a little. One patient （ 5. 3% ） complained constipation after operation, which did not exist before operation. Conclusion The Delorme＇ s procedure is an effective method to treat the rectal prolapse with marked improvement of anal incontinence,lower recurrence rate and lower incidence of postoperative constipation.