External rectal prolapse:abdominal or perineal repair for men?A retrospective cohort study  

作　　者：Bang Hu Qi Zou Zhenyu Xian Dan Su Chao Liu Li Lu Minyi Luo Zixu Chen Keyu Cai Han Gao Hui Peng Wuteng Cao Donglin Ren 

机构地区：[1]Department of Colorectal and Anal Surgery,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China [2]Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,Guangdong Institute of Gastroenterology,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China [3]Department of Digestive Center,PanYu Central Hospital,Guangzhou,Guangdong,P.R.China [4]Department of Microbiology,Zhongshan School of Medicine,Key Laboratory for Tropical Diseases Control of the Ministry of Education,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China [5]Department of Radiology,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China

出　　处：《Gastroenterology Report》2022年第1期277-283,共7页胃肠病学报道（英文）

基　　金：supported by the Guangdong Medical Research Fund Project[grant number A2021171].

摘　　要：Background:External rectal prolapse is a relatively rare disease,in which male patients account for a minority.The selection of abdominal repair or perineal repair for male patients has rarely been investigated.Methods:Fifty-one male patients receiving abdominal repair(laparoscopic ventral rectopexy)or perineal repair(Delorme or Altemeier procedures)at the Sixth Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between March 2013 and September 2019 were retrospectively analysed.We compared the recurrence,complication rate,post-operative defecation disorder,length of stay,and quality of life between the abdominal and perineal groups.Results:Of the 51 patients,45 had a complete follow-up,with a median of 48.5 months(range,22.8–101.8 months).A total of 35 patients were under age 40 years.The complication rate associated with abdominal repair was less than that associated with perineal repair(0%vs 20.7%,P=0.031)and the recurrence rate was also lower(9.5%vs 41.7%,P=0.018).Multivariate analysis showed that perineal repair(odds ratio,9.827;95%confidence interval,1.296–74.50;P=0.027)might be a risk factor for recurrence.Moreover,only perineal repair significantly improved post-operative constipation status(preoperative vs post-operative,72.4%vs 25.0%,P=0.001).There was no reported mortality in either of the groups.No patient’s sexual function was affected by the surgery.Conclusions:Both surgical approaches were safe in men.Compared with perineal repair,the complication rate and recurrence rate for abdominal repair were lower.However,perineal repair was better able to correct constipation.

关 键 词：external rectal prolapse male laparoscopic ventral rectopexy Altemeier Delorme 

分 类 号：R735.37[医药卫生—肿瘤]