RESULTS OF RECTOCELE REPAIR - A PROSPECTIVE-STUDY
RESULTS OF RECTOCELE REPAIR - A PROSPECTIVE-STUDY
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DOI：
10.1007/bf02053850
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发表时间：
1995-01-01
影响因子：
3.9
通讯作者：
HOLMSTROM, B
中科院分区：
文献类型：
--
作者：
MELLGREN, A;ANZEN, B;HOLMSTROM, B
目得：本研究旨在评估直肠前突修补术的结果和可能有助于选择患者进行该手术的参数。方法：25例直肠前突患者采用标准化问卷调查、体格检查、排粪造影、结肠传输研究、肛门直肠测压和电生理检查进行前瞻性评估。患者接受了阴道后壁缝合术和会阴缝合术。术后随访（平均1.0年），采用相同的问卷调查、体格检查、排粪造影、肛门直肠测压和电生理检查。结果：24例便秘患者中有21例（88%）术后便秘得到改善。在术后随访中，13名患者（52%）没有便秘症状，8名患者（32%）偶尔出现症状，4名患者（16%）每周出现一次以上症状。4例术前排粪造影而非体格检查时发现直肠前突的患者，术后结果良好。大多数术前未使用阴道数字化的患者在便秘方面有所改善。Au患者术后均有不同程度的便秘。5例术前括约肌反常反应的患者中有2例的便秘没有改善。结论：直肠前突是引起便秘的原因之一，治疗效果良好。术前使用阴道数字化并不是术后良好结果的强制性要求。排粪造影是体格检查的重要补充。病理性运输研究的患者在直肠前突修补术中便秘的结局可能较差。需要更多关于这些患者括约肌反常反应的重要性的研究。
PURPOSE: This study was designed to evaluate the results of rectocele repair and parameters that might be useful in selecting patients for this operation. METHODS: Twenty-five patients with symptom-giving rectoceles were prospectively evaluated with a standardized questionnaire, physical examination, defecography, colon transit studies, anorectal manometry, and electrophysiology. Patients underwent posterior colporrhaphy and perineorrhaphy. They were followed postoperatively (mean, 1.0 year) with the same questionnaire, physical examination, defecography, anorectal manometry, and electrophysiology. RESULTS: Constipation had improved postoperatively in 21 of 24 constipated patients (88 percent). At postoperative follow-up 13 patients (52 percent) had no constipation symptoms, 8 (32 percent) had occasional symptoms, and 4 (16 percent) had symptoms more than once per week. Four patients with rectocele at preoperative defecography, but not at physical examination, had favorable outcomes following surgery. The majority of patients not using vaginal digitalization preoperatively had improved with respect to constipation. AU patients with pathologic transit studies had various degrees of constipation postoperatively. Constipation was not improved in two of five patients with preoperative paradoxic sphincter reaction. CONCLUSIONS: Rectocele is one cause of constipation that can be treated with good results. Preoperative use of vaginal digitalization is not mandatory for a good postoperative result. Defecography is an important complement to physical examination. Patients with pathologic transit study might have a less favorable outcome of rectocele repair with respect to constipation. More studies about the significance of paradoxic sphincter reaction in these patients are indicated.