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Surgical Treatment of Rectal Prolapse

机译:直肠脱垂的外科治疗

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Rectal prolapse is defined as a protrusion of the rectum beyond the anus. Although rectal prolapse was recognized as early as 1500 BC, the optimal surgical procedure is still debated. The varied operative procedures available for treating rectal prolapsed can be confusing. The aim of treatment is to control the prolapse, restore continence, and prevent constipation or impaired evacuation. In elderly and high-risk patients, perineal approaches, such as Delorme's operation and Altemeier's operation, have been preferred, although the incidence of recurrence and the rate of persistent incontinence seem to be high when compared with transabdominal procedures. Abdominal operations involve dissection and fixation of the rectum and may include a rectosigmoid resection. From the late twentieth century, the laparoscopic procedure has been applied to the treatment of rectal prolapse. Current laparoscopic surgical techniques include suture rectopexy, stapled rectopexy, posterior mesh rectopexy with artificial material, and resection of the sigmoid colon with colorectal anastomosis with or without rectopexy. The choice of surgery depends on the status of the patient and the surgeon's preference.
机译:直肠脱垂定义为直肠超出肛门的突出部分。尽管早在公元前1500年就已认识到直肠脱垂,但关于最佳手术方法仍存在争议。可用于治疗直肠脱垂的各种手术程序可能会令人困惑。治疗的目的是控制脱垂,恢复节制,并防止便秘或排泄障碍。在老年和高危患者中,会阴方法,例如Delorme手术和Altemeier手术,是首选的,尽管与经腹手术相比,复发率和持续性尿失禁的发生率似乎很高。腹部手术涉及直肠的解剖和固定,可能包括直肠乙状结肠切除术。从二十世纪后期开始,腹腔镜手术已被用于治疗直肠脱垂。当前的腹腔镜手术技术包括缝线切开术,钉书钉切开术,用人造材料缝合后网状切开术,以及在有或没有切开术的大肠吻合术中切除乙状结肠。手术的选择取决于患者的状况和外科医生的偏好。

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