Complete rectal prolapse,characterized by the protrusion of the rectal wall layers through the anal canal,poses significant treatment challenges,particularly due to controversies surrounding surgical approaches and th...Complete rectal prolapse,characterized by the protrusion of the rectal wall layers through the anal canal,poses significant treatment challenges,particularly due to controversies surrounding surgical approaches and the absence of a standardized assessment system.This study comprehensively reviews the main surgical tech-niques for complete rectal prolapse,categorized as transabdominal and transpe-rineal/transanal procedures.Despite various techniques,challenges persist,inclu-ding high recurrence rates and potential complications.Factors influencing the choice of the surgical approach include patient characteristics,symptomatology,and surgical expertise.With advances in medical technology,laparoscopic and robotic surgeries offer promising avenues,albeit with considerations of cost and accessibility.Ultimately,treatment plans tailored to the individual needs of the patient and surgical expertise are essential.Although controversies remain,the continued refinement of surgical techniques holds promise for improving out-comes in complete rectal prolapse surgery.展开更多
目的:探讨经自然腔道取标本手术治疗直肠脱垂的应用价值及近期疗效分析。方法:回顾分析2019年1月至2023年3月收治的41例直肠脱垂患者的临床资料。其中15例行经自然腔道取标本手术(观察组),26例行传统腹腔镜手术(对照组)。对比分析两组...目的:探讨经自然腔道取标本手术治疗直肠脱垂的应用价值及近期疗效分析。方法:回顾分析2019年1月至2023年3月收治的41例直肠脱垂患者的临床资料。其中15例行经自然腔道取标本手术(观察组),26例行传统腹腔镜手术(对照组)。对比分析两组手术时间、术中出血量、术后住院时间、术后疼痛评分、术后并发症及复发率,评估肛门括约肌功能、Wexner肛门失禁评分及便秘评分。结果:观察组与对照组术中出血量差异无统计学意义[48(42,50)mL vs. 47(45,50)mL,P>0.05],手术时间[(147.20±5.51)min vs.(132.61±5.88)min]、住院时间[7(6,8)d vs.12(10,13)d]、术后疼痛评分[2(1,3)分vs.5(4,6)分]差异有统计学意义(P<0.05)。术后两组肛门括约肌评分、Wexner肛门失禁评分、Wexner便秘评分与术前相比均降低,差异有统计学意义(P<0.05),两组间差异无统计学意义(P>0.05)。对照组发生3例腹壁辅助切口脂肪液化。术后无围手术期死亡,随访6个月无复发病例。结论:经自然腔道取标本手术应用于直肠脱垂的治疗安全、可行,具有康复快、术后疼痛轻、便秘与肛门失禁明显改善、复发率低的优点,值得临床推广应用。展开更多
基金Supported by Science and Technology Fund Project of Guizhou Health Commission,No.gzwkj2023-042 and No.gzwkj2024-010National Natural Science Foundation of China,No.82060440+2 种基金Guizhou Provincial Science and Technology Projects,No.QKHJC ZK[2024]-210Cultivation Program for General Projects of the National Natural Science Foundation of China,No.gyfynsfc[2023]-01Cultivation Program for Regional Projects of the National Natural Science Foundation of China,No.gyfynsfc[2024]-19.
文摘Complete rectal prolapse,characterized by the protrusion of the rectal wall layers through the anal canal,poses significant treatment challenges,particularly due to controversies surrounding surgical approaches and the absence of a standardized assessment system.This study comprehensively reviews the main surgical tech-niques for complete rectal prolapse,categorized as transabdominal and transpe-rineal/transanal procedures.Despite various techniques,challenges persist,inclu-ding high recurrence rates and potential complications.Factors influencing the choice of the surgical approach include patient characteristics,symptomatology,and surgical expertise.With advances in medical technology,laparoscopic and robotic surgeries offer promising avenues,albeit with considerations of cost and accessibility.Ultimately,treatment plans tailored to the individual needs of the patient and surgical expertise are essential.Although controversies remain,the continued refinement of surgical techniques holds promise for improving out-comes in complete rectal prolapse surgery.
文摘目的:探讨经自然腔道取标本手术治疗直肠脱垂的应用价值及近期疗效分析。方法:回顾分析2019年1月至2023年3月收治的41例直肠脱垂患者的临床资料。其中15例行经自然腔道取标本手术(观察组),26例行传统腹腔镜手术(对照组)。对比分析两组手术时间、术中出血量、术后住院时间、术后疼痛评分、术后并发症及复发率,评估肛门括约肌功能、Wexner肛门失禁评分及便秘评分。结果:观察组与对照组术中出血量差异无统计学意义[48(42,50)mL vs. 47(45,50)mL,P>0.05],手术时间[(147.20±5.51)min vs.(132.61±5.88)min]、住院时间[7(6,8)d vs.12(10,13)d]、术后疼痛评分[2(1,3)分vs.5(4,6)分]差异有统计学意义(P<0.05)。术后两组肛门括约肌评分、Wexner肛门失禁评分、Wexner便秘评分与术前相比均降低,差异有统计学意义(P<0.05),两组间差异无统计学意义(P>0.05)。对照组发生3例腹壁辅助切口脂肪液化。术后无围手术期死亡,随访6个月无复发病例。结论:经自然腔道取标本手术应用于直肠脱垂的治疗安全、可行,具有康复快、术后疼痛轻、便秘与肛门失禁明显改善、复发率低的优点,值得临床推广应用。
