Clinical effect of laparoscopic rectal suspension with basin repair combined with the PPH for rectal internal mucosal prolapse

doi:10.3877/cma.j.issn.2095-3224.2017.06.008

Abstract

Abstract:

Objective

To analyze clinical efficacy of laparoscopic rectal suspension with basin repair combined with the PPH for rectal internal mucosal prolapse.

Methods

From March 2011 to November 2012, 94 cases of patients who had internal rectal mucosal prolapse were treated.Patients were divided into two groups in terms of different surgical techniques.Group A (n=48) received laparoscopic rectal suspension with basin repair combined with the PPH,Group B (n=46) received PPH.Longo Score and Wexner Score,postoperative effect,postoperative complications in the two groups were assessed respectively before surgery and 24 months after surgery.

Results

The average preoperative Longo score of A,B two groups were 15.39±4.15、14.86±3.06,after 24 months fell to 5.37±0.87、7.84±1.23. Group A (t=16.37, P<0.01) and group B (t=14.46, P<0.01) within the group of preoperative and postoperative comparative difference was statistically significant. Average Longo score of group A after 24 months were significantly lower than those of group B (t=-11.28, P<0.01), the difference was statistically significant.The average preoperative Wexner score of A, B two groups were 14.25±3.37、14.58±3.14, after 24 months fell to 4.85±0.51、7.52±0.94. Group A (t=19.11, P<0.01) and group B (t=14.61, P<0.01) within the group of preoperative and postoperative comparative difference was statistically significant.Average Wexner score of group A after 24 months were significantly lower than those of group B (t=-17.21, P<0.01), the difference was statistically significant. The total effective rate among the two groups was statistically significant (χ²=5.84, P<0.05). The complications of two groups were not statistically insignificant (χ²=0.20, P>0.05).

Conclusion

The short term efficacy of laparoscopic rectal suspension with basin repair combined with the PPH is better than PPH, but the long term effect need further research.

Key words: Rectum, Rectal suspension, Rectal internal mucosal prolapse, Basin repair

Chao Wang, Yang Yang, Weiwei Yang, Yongli Cao, Dong Wei. Clinical effect of laparoscopic rectal suspension with basin repair combined with the PPH for rectal internal mucosal prolapse[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2017, 06(06): 484-487.

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Figures/Tables 4

References 14

1	Rao SS,Rattankovit K,Patcharatrakul T. Diagnosis and management of chronic constipation in adults [J]. Nat Rev Gastroenterol Hepatol, 2016, 13(5): 295-305.
2	Drossman DA. The functional gastrointestinal disorders and the Rome Ⅲ process [J]. Gastro-enterology, 2006, 130(5): 1377-1390.
3	中华医学会消化病学分会胃肠动力学组, 中华医学会外科学分会结直肠肛门外科学组. 中国慢性便秘诊治指南(2013年武汉) [J]. 中华消化杂志, 2013, 33(5): 291-296.
4	中华医学会外科学分会肛肠外科学组.修订《痔上黏膜环形切除术（PPH）暂行规范》会议纪要 [J]. 中华胃肠外科杂志, 2005, 8(4): 374.
5	Zhang B,Ding JH,Zhao YJ, et al. Midterm outcome of stapled transanal rectal resection for obstructed defecation syndrome: a single-institution experience in China [J]. World J Gastroenterol, 2013, 19 (38): 6472-6478.
6	De la Torre L,Langer JC. Transanal endorectal pull-through for Hirschsprung disease: technique, Controversies, peals, pitfalls, and an organized approach to the management of postoperative obstructive symptoms [J]. Semin Pediatr Surg, 2010, 19(2): 96-106.
7	刘韦成,江从庆,钱群, 等.出口梗阻型便秘的外科治疗进展 [J]. 临床外科杂志. 2017, 25(4): 310-313.
8	刘智勇,杨关根,邓群, 等.部分吻合器经肛门直肠切除术联合Bresler术治疗直肠前突合并直肠内套叠疗效观察 [J]. 中华胃肠外科杂志, 2016, 19(5): 566-570.
9	刘毅,崔金杰,杨新庆.经肛吻合器直肠部分切除术在排便障碍型便秘治疗中应用的长期效果评价 [J]. 临床外科杂志, 2015, 23(10): 744-746.
10	周雪涛,王振军,郑毅, 等.痔上黏膜环切术与经肛门直肠切除术的并发症相关因素分析 [J]. 中华普通外科杂志, 2016, 31(12): 1011-1014.
11	Lu M,Yang B,Liu Y, et al. Procedure for prolapse and Hemorrhoids VS traditional surgery for outlet obstructive constipation [J]. World Journal of Gastroenterology, 2015, 21(26): 8178-8183.
12	李春穴,刘高磊,童卫东, 等.直肠功能性悬吊术治疗直肠内脱垂30例分析 [J]. 中国实用外科杂志, 2013, 33(11): 958-959.
13	Sileri P,Franceschilli L,de Luca E, et al. Laparoscopic ventral rectopexy for internal rectal prolapse using biological mesh : postoperative and short-term functional results [J]. World Tournal of Gastroenterology, 2012, 16(3): 622-628.
14	Owais AE,Sumrien H,Mabey K, et al. Laparoscopic ventral mesh rectopexy in male patients with internal or external rectal prolapse [J]. Colorectal Disease, 2014, 16(12): 995-1000.

一般资料		A组（n=48）	B组（n=46）	检验值	P值
年龄（岁）		49.45±14.22	50.17±10.78	t=-0.28	0.78
性别（例）				χ²=0.96	0.33
	男	5	8
	女	43	38
病史（年）		17.79±3.10	17.24±4.31	t=0.71	0.48
便秘症状评分（分）		15.39±4.15	14.86±3.06	t=0.70	0.49
便秘严重程度评分（分）		14.25±3.37	14.58±3.14	t=-0.05	0.62
合并痔疮（例）				χ²=2.70	0.10
	是	15	22
	否	33	24
合并直肠前突（例）				χ²=1.15	0.28
	是	23	17
	否	25	29
合并会阴下降（例）				χ²=0.57	0.45
	是	9	6
	否	39	40

一般资料		A组（n=48）	B组（n=46）	检验值	P值
年龄（岁）		49.45±14.22	50.17±10.78	t=-0.28	0.78
性别（例）				χ²=0.96	0.33
	男	5	8
	女	43	38
病史（年）		17.79±3.10	17.24±4.31	t=0.71	0.48
便秘症状评分（分）		15.39±4.15	14.86±3.06	t=0.70	0.49
便秘严重程度评分（分）		14.25±3.37	14.58±3.14	t=-0.05	0.62
合并痔疮（例）				χ²=2.70	0.10
	是	15	22
	否	33	24
合并直肠前突（例）				χ²=1.15	0.28
	是	23	17
	否	25	29
合并会阴下降（例）				χ²=0.57	0.45
	是	9	6
	否	39	40

组别	有效		无效	有效率（%）
组别	治愈	好转	无效	有效率（%）
A组	27	16	5	89.6
B组	15	17	14	69.6
χ²值				5.84
P值				0.02

组别	有效		无效	有效率（%）
组别	治愈	好转	无效	有效率（%）
A组	27	16	5	89.6
B组	15	17	14	69.6
χ²值				5.84
P值				0.02

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