TST STARR＋治疗出口梗阻型便秘术后并发症及分析

Complications of TST Stapled Transanal Rectal Resection Plus in the Treatment of Outlet Obstruction Constipation

目的探讨改良性经肛门吻合器直肠部分切除术（TST stapled transanal rectal resection plus）治疗出口梗阻型便秘（obstructed defecation syndrome，ODS）的并发症产生原因及防治。方法对2013年4月至2015年8月间武汉大学中南医院采用TSTSTARR＋治疗186例ODS病例的临床资料行回顾性分析。结果术中并发症包括吻合器切割不全4例、活动性出血71例；术后短期并发症包括吻合口出血3例、尿潴留63例、疼痛38例、排便急迫感或首次排便失禁20例；中位随访13个月，远期并发症包括吻合口狭窄1例、肛门坠胀1例、肛门失禁1例。结论TSTSTARR＋是治疗出口梗阻型便秘相对安全的术式。

Objective To evaluate the causes of complications of TST stapled transanal rectal resection plus （TST STARR ＋ ）in the treatment of outlet obstruction constipation（OOC） and discuss prevention and treatment meas- ures. Methods A retrospective study was performed in 286 patients with OOC underwent TST STARR ＋. Results Intraoperative complications included incomplete cutting stapler in 4 patients and active bleeding in 71 patients. Short -term postoperative complications included anastomotic bleeding in 3 patients, urinary retention in 63 patients, pain in 38 patients,and defecation urgency or fecal incontinence for the first time in 20 patients. The median follow -up was 13 months. Long- term complications included anastomotic stenosis in 1 patient, anal pendant expansion in 1 pa- tient and anal incontinence in 1 patient. Conclusion TST STARR ＋ appears to be a safe technique for patients with OOC.