经肛门与经阴道直肠前突修补术回顾性分析50例

Transanal vs transvaginal repair of symptomatic rectocele: Analysis of 50 cases

目的:通过比较经肛门与经阴道直肠前突修补术的临床疗效,根据术后直肠前突深度的变化,确定其长期临床效果.方法:将50例直肠前突女性患者随机分为A、B两组,A组25例采用经肛门修补术,B组25例采用经阴道修补术.对两组患者术后相关指标进行观察,并进行统计学分析.结果:术后12 mo,两组中各有17例患者(A组/B组:77%/74%)症状改善.中位随访50 m o,两组中各有11例和13例患者(A组/B组:55%/59%)症状改善.患者术后直肠前突深度变化越大(≥4 cm),长期疗效越好(P=0.001).结论:在这两种手术方式中,随着随访时间延长,临床疗效逐渐下降.而术前直肠前突越重的患者,术后长期疗效越好.

AIM：To compare the results of transanal vs transvaginal repair of symptomatic rectocele and to determine the long-term clinical outcomes according to the change in the depth of the rectocele after the procedure.METHODS：This study included 50 women suffering from rectocele.They were randomized into two groups：25 women（group A） receiving a transanal repair and 25（group B） receiving a transvaginal repair.The relevant postoperative indexes were compared for the two groups.RESULTS：At 12 mo after surgery,17 women in each group（group A/B,77%/74%） reported improvement of their symptoms.However,only 11 and 13 women of groups A and B（group A/B,55%/59%）,respectively,maintained their improvement during the median follow-up of50 mo.Better results were reported in patients with a greater change in the depth of their rectocele（≥4cm） after the procedure（P = 0.001）.CONCLUSION：In both procedures,clinical outcomes might become progressively worse as the length of the follow-up is increased.A preoperative larger rectocele might have a better postoperative outcome.