Transanal rectocele repair using EndoGIA: short-term results of a prospective study.
Transanal rectocele repair using EndoGIA: short-term results of a prospective study.
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DOI：
10.1007/s10151-005-0207-4
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发表时间：
2005-07-01
影响因子：
3.3
通讯作者：
Chimenti, C
中科院分区：
文献类型：
--
作者：
D'Avolio, M;Ferrara, A;Chimenti, C
背景：对症性直肠前突的手术治疗可以通过直肠内技术进行。结果取决于对相关疾病的正确病因评估。我们报告一种原始的直肠内技术应用于选定患者的初步结果。方法：15名女性（中位年龄57岁，范围38-73岁）接受经肛门直肠前突切除术，经60毫米内镜下切除直肠前壁。所有患者均有原发性孤立性前中提肛前突伴排便障碍症状。术前采用问卷调查、排便日记、临床检查、排便造影术、肛门测压等方法对患者进行前瞻性评价。所有患者每周排便次数均少于三次。术后随访包括1周、1个月、3个月的临床检查、症状问卷及排便日记；3个月时行排便造影。结果：修复直肠膨出所需时间约为20分钟。术后平均住院时间37 h。所有病例术后均为中低疼痛，1例出现急性尿潴留，11例出现轻微直肠出血，5例出现暂时性急症。所有患者均消除了过度紧张、不完全排便感、灌肠和自指现象；3个月大便次数：10例为每周7次，3例为每周5-6次，2例为每周4-6次(p
BACKGROUND: The surgical treatment of symptomatic rectocele may be carried out by means of endorectal techniques. Results depend on a correct etiologic evaluation of associated diseases. We report the preliminary results of an original endorectal technique applied to selected patients.METHODS: Fifteen women (median age, 57 years; range, 38-73 years) underwent transanal rectocele resection by a 60 mm endo-GIA and subsequent plication of the anterior rectal wall. All patients had a primary isolated anterior medium sublevator rectocele with obstructed defecation symptoms. They were prospectively evaluated by questionnaire, defecation diary, clinical examination, defecography and anal manometry were performed preoperatively. All patients had less than three weekly bowel motions. Postoperative follow-up included clinical examination and symptoms questionnaire with defecation diary at one week, one month and three months; defecography was performed at three months.RESULTS: The time required to repair the rectocele was approximately 20 min. The mean time spent in hospital after the operation was 37 h. Postoperative pain was low or moderate in all cases, one patient had acute urinary retention, 11 had minor rectal bleeding, and 5 had temporary urgency. Abolition of excessive straining, feeling of incomplete evacuation, enemas and self-digitations was achieved in all patients; stool frequency at three months was 7 per week in 10 patients, 5-6 per week in 3 patients and 4-6 in 2 patients (p