腹腔镜直肠悬吊术在完全性直肠脱垂中的个体化应用及体会  

Individual application and experience of laparoscopic rectal suspension in complete rectal prolapse

作　　者：陈伟 王海鹏 艾常华 CHEN Wei;WANG Hai-peng;AI Chang-hua(Department of Gastroenterology Surgery,the Second Affiliated Hospital of Guilin Medical University,Guilin 541199,China)

机构地区：[1]桂林医学院第二附属医院胃肠外科,广西桂林541199

出　　处：《腹腔镜外科杂志》2021年第7期517-519,529,共4页Journal of Laparoscopic Surgery

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190450)。

摘　　要：目的:探讨腹腔镜手术治疗完全性直肠脱垂的术式选择及临床疗效。方法:回顾分析2015年6月至2019年12月为16例完全性直肠脱垂患者行腹腔镜直肠悬吊术及联合其他术式治疗的临床资料,其中5例单纯行腹腔镜直肠悬吊术,6例行腹腔镜直肠悬吊+冗长结肠切除术,3例行腹腔镜直肠悬吊+吻合器痔上黏膜环切术,2例行腹腔镜直肠悬吊+冗长结肠切除+肛门环缩术。结果:16例手术均顺利完成,无中转开腹,术后患者恢复顺利,无并发症发生,术后2~3 d肛门排气,住院6~12 d,平均(8.0±1.8)d。术后随访8~60个月,均未见复发,16例患者术后排便情况良好,生活质量改善。结论:以腹腔镜直肠悬吊术为基础的个体化方案治疗完全性直肠脱垂是安全、可行的,临床疗效满意,值得推广。Objective:To investigate surgical selection and clinical efficacy of laparoscopic surgery in the treatment of complete rectal prolapse.Methods:The clinical data of 16 patients with complete rectal prolapse who underwent laparoscopic rectal suspension and the combination of other surgical treatments from Jun.2015 to Dec.2019 were retrospectively analyzed,including 5 cases of simple laparoscopic rectal suspension,6 cases of laparoscopic rectal suspension combined with redundant colectomy,3 cases of laparoscopic rectal suspension combined with procedure for prolapse and hemorrhoids,and 2 cases of laparoscopic rectal suspension combined with redundant colectomy and anal ring retraction.Results:The 16 surgeries were successful without conversion to laparotomy or complications,patients smoothly recovered after operation.Time of postoperative anal exhaust was 2-3 d,hospital stay was 6-12 d with the average of(8.0±1.8)d.The 8-60 months follow-up observation indicated no evidence of recurrence.The 16 patients showed satisfactory postoperative defecation and improved life quality.Conclusions:The individual application of laparoscopic rectal suspension in complete rectal prolapse is safe and feasible,and the clinical efficacy is satisfactory.It deserves to be recommended in the clinical application.

关 键 词：完全性直肠脱垂 腹腔镜检查 直肠悬吊术 

分 类 号：R657.19[医药卫生—外科学]