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Perineal stapled prolapse resection for external rectal prolapse: is it worthwhile in the long-term?

机译:对外直肠脱垂的会阴包膀胱脱垂:是在长期的价值吗?

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摘要

BACKGROUND: Perineal stapled prolapse (PSP) resection is a novel operation for treating external rectal prolapse. However, no long-term results have been reported in the literature. This study analyses the long-term recurrence rate, functional outcome, and morbidity associated with PSP resection.METHODS: Nine consecutive patients undergoing PSP resection between 2007 and 2011 were prospectively followed. Surgery was performed by the same surgeons in a standardised technique. Recurrence rate, functional outcome, and complication grade were prospectively assessed.RESULTS: All 9 patients undergoing PSP resection were investigated. The median age was 72 years (range 25-88 years). No intraoperative complications occurred. Faecal incontinence, preoperatively present in 2 patients, worsened postoperatively in one patient (Vaizey 18-22). One patient developed new-onset faecal incontinence (Vaizey 18). The median obstructive defecation syndrome score decreased postoperatively significantly from 11 (median; range 8-13) to 5 (median; range 4-8) (p  0.005). At a median follow-up of 40 months (range 14-58 months), the prolapse recurrence rate was 44 % (4/9 patients).CONCLUSIONS: The PSP resection is a fast and safe procedure associated with low morbidity. However, the poor long-term functional outcome and the recurrence rate of 44 % warrant a cautious patient selection.
机译:背景:Perineal吻合脱垂(PSP)切除是一种治疗外肠脱垂的新手术。但是,文献中没有报告长期结果。本研究分析了与PSP分解相关的长期复发率,功能性结果和发病率。预先遵循2007年至2011年间PSP切除的九个连续患者。在标准化技术中由相同的外科医生进行手术。次要评估复发率,功能结果和并发症等级。结果:调查所有9例接受PSP切除的患者。中位年龄为72岁(范围25-88岁)。没有发生术中并发症。粪便失禁,术前呈现在2名患者中,术后一名患者(Vaizey 18-22)术后恶化。一名患者开发了新的粪便失禁(Vaizey 18)。中位阻塞性排便综合征评分从11(中位数; 8-13)到5(中位数;范围4-8)(P <0.005),显着下降术后显着下降在40个月(14-58个月的范围)中,脱垂复发率为44%(4/9患者)。结论:PSP切除是一种与低发病率相关的快速安全的程序。然而,长期功能结果差,44%的复发率保证谨慎患者选择。

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